TE2 DD Form 1532 Pest Management Report.xlsx
XLSX spreadsheet 1 MB Posted
- Attached to
- Termite Treatment & Fumigation Services
- Solicitation number
- W912CN-26-Q-A011
About this file
This is a Pest Management Report template in spreadsheet format (DD Form 1532) associated with a termite treatment and fumigation services solicitation for US Army Hawaii installations.
The template is designed to document pest management activities for the solicitation W912CN-26-Q-A011, issued by the Department of the Army Materiel Command Army Contracting Command Regional Contracting Office Hawaii. The spreadsheet serves as a reporting tool for contractors to track and record termite treatment and fumigation services (both subterranean and dry-wood termites) performed on various buildings across Oahu, Hawaii Army installations. As a DD Form 1532 template, this document would typically capture service dates, treatment locations, pest types, treatment methods applied, chemical products used, certifications of personnel performing the work, and compliance documentation. The form functions as both an operational record and a means of demonstrating contract performance and regulatory compliance for the firm fixed-price contract with one base year and four option years. Prospective vendors are required to understand and utilize this reporting format as part of their contractual obligations under this 100% small business set-aside solicitation conducted under FAR Part 12 procedures.
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Instructions Pest Management Report (DD Form 1532)/Pest Management Maintenance Record (DD Form 1532-1) Instructions
This spreadsheet meets the DoDI 4150.07 (DoD Pest Management Program) and DoDI 6490.03 (Deployment Health) requirements for recording and reporting pest management operations and pesticide use during military deployments. The spreadsheet consists of the following worksheets: Instructions; Pesticides Applied; New Pesticides Applied; Surveillance, Non-Chemical and Animal Control; and Example(s). The "Pesticides Applied" worksheet is populated with the EPA registration numbers and trade names of the pesticides approved by the AFPMB for DLA stockage and Contingency Usage as well as pesticides previously approved and applied during military deployments and reported on DD Form 1532's. The "New Pesticides Applied" worksheet allows the user to type in the EPA Registration Number and Pesticide Trade Name for pesticides that were applied but don't appear as a choice in the EPA Registration Number drop down list in the "Pesticides Applied" worksheet. Use the "Surv NonChemical Animal Control" worksheet for recording information related to surveillance, non-chemical control, and animal control. The "Example(s)" worksheet provides samples of how these worksheets should be completed. These worksheets were formatted as an excel spreadsheet so that they can be easy for the user to complete and compatible for permanent archiving by the Defense Centers for Public Health - Aberdeen into the Defense Occupational and Environmental Health Readiness System (DOEHRS).
| Submit this spreadsheet by the 15th day after the end of each month. Complete a separate spreadsheet for each location (base camp, FOB, etc.). Follow this format when naming/saving each spreadsheet: YEAR_MONTH_RAW_CAMP (example: 2020_JUL_RAW_DAHLKE.xls). Please refer to the cells above each column header which explains what needs to be filled out for each of the 3 worksheets. Remember to fill out each column and save your work frequently. If you need help filling out this spreadsheet, contact the DoD Pesticide Hotline at: |
| dha.apg.pub-health-a.mbx.pesticide-hotline@health.mil |
When you are finished, save the spreadsheet as an Excel Macro-Enabled Workbook and send it to the appropriate email address below:
| Army: NIPRNet: |
| dha.apg.pub-health-a.mbx.pesticide-archival@health.mil |
| Navy: (Contingency) |
| usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-pesticiderpts@mail.mil |
| Navy: (Shipboard) |
| usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-pesticiderpts@mail.mil |
| Air Force: |
| Through your MAJCOM PMP |
| Joint Operations: |
| Submit the spreadsheet to the authority directed by your Theater Command |
mailto:dha.apg.pub-health-a.mbx.pesticide-hotline@health.milmailto:dha.apg.pub-health-a.mbx.pesticide-archival@health.milmailto:usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-pesticiderpts@mail.milmailto:usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-pesticiderpts@mail.mil Pesticides Applied
| Please complete this worksheet if a pesticide product was applied. |
| Country |
| POC/Unit: |
| Type in the date that the pesticide was applied. The preferred format is YYYY-MM-DD (i.e. 2020-07-22). | The name of the country where the pesticide was applied should automatically populate based on the selection made in the "Country" cell above. | Select the DOEHRS base camp name from the drop down list below where the pesticide was applied. If the location is not listed, please type in the current name of the base camp. | Select the specific site of application from the drop down list where the pesticide was applied (i.e. bldg #, activity name, etc.) . If the site is not listed, please type in the site of application. | Select the origin for why the pesticide was applied from the drop down list (i.e. work order, etc.). | Select the type of operation performed from the drop down list (i.e. Exterior Bait). | Select a target pest that you were attempting to manage/control from the drop down list (i.e. Rodents). If the target pest isn't listed, then write the target pest in the additional comments field. | Type in the size of the area treated (i.e. 100). | Select the appropriate units of measure (i.e. square feet, meters, acres, etc.) related to the area treated from the drop down list. | Select the Environmental Protection Agency Registration Number (EPA Reg. No. on product label) of the pesticide applied from the drop down list (i.e. 12455-79). If the number doesn't appear, please go to the worksheet called "New Pesticides Applied" to manually enter the EPA Registration Number. | If the EPA Registration Number is selected, the pesticide trade name will automatically populate in this column (i.e. CONTRAC All-Weather Blox). | If the EPA Registration Number is selected, the product formulation will automatically populate in this column (i.e. Pelleted/Tabletted). | If the EPA Registration Number is selected, the active ingredient percentage for the product will automatically populate in this column (i.e. 0.005). | Type in the amount of concentrate used for mixing. If the product does not require mixing and is ready to be used please select "N/A". | Select the appropriate units of measure related to the amount of concentrate from the drop down list (i.e. ounce, pound, etc.). If the product does not require mixing and is ready to be used please select "N/A". | Type in the Final % Concentration in the Finished Product. If the product does not require mixing and is ready to be used please select "N/A". | Type in the amount of finished product applied. For products that are formulated as Aerosols, please indicate the number of can(s) used. This estimate will be useful in calculating the total Pounds of Active Ingredient (PAI) applied. | Select the appropriate units of measure related to the amount of finished product applied from the drop down list (i.e. ounce, pound, etc.). | Type in the name of the person (i.e. John Doe) who applied the pesticide. | Type in the applicator's DoD FIFRA, DoD Non-FIFRA, or State Certification Number. | Type in the exact time in which the pesticide was applied at the site. The preferred format is hh:mm (i.e. 09:45). | Type in the total time invested by all applicators in the operation in hours (i.e. 1 or 0.5). | Provide any additional comments. |
| Date | Country | Base Camp | Site of Application | Origin | Operation | Target Pest | Area Treated | Units of Measure for the Area Treated | EPA Registration Number | Pesticide Trade Name | Product Formulation | Active Ingredient Percentage | Amount of Concentrate Used for Mixing | Units of Measure for the Amount of Concentrate Used for Mixing | Final % Concentration in Finished Product | Amount of Finished Product Applied | Units of Measure for the Amount of Finished Product Applied | Applicator Name | Applicator Certification # | Time Pesticide was Applied | Total Time Invested in Hours | Additional Comments |
New Pesticides Applied
| Please complete this worksheet if the EPA Registration Number of the pesticide product applied was not found in the dropdown list of the Pesticides Applied worksheet. |
| Country |
| POC/Unit: |
| Type in the date that the pesticide was applied. The preferred format is YYYY-MM-DD (i.e. 2020-07-22). | The name of the country where the pesticide was applied should automatically populate based on the selection made in the "Country" cell above. | Select the DOEHRS base camp name from the drop down list below where the pesticide was applied. If the location is not listed, please type in the current name of the base camp. | Select the specific site of application from the drop down list where the pesticide was applied (i.e. bldg #, activity name, etc.) . If the site is not listed, please type in the site of application. | Select the origin for why the pesticide was applied from the drop down list (i.e. work order, etc.). | Select the type of operation performed from the drop down list (i.e. Exterior Bait). | Select a target pest that you were attempting to manage/control from the drop down list (i.e. Rodents). If the target pest isn't listed, then write the target pest in the additional comments field. | Type in the size of the area treated (i.e. 100). | Select the appropriate units of measure (i.e. square feet, meters, acres, etc.) related to the area treated from the drop down list. | Type in the Environmental Protection Agency Registration Number (EPA Reg. No. on product label) of the pesticide applied (i.e. 12455-79). | Type in the pesticide trade name (i.e. CONTRAC All-Weather Blox). | Type in the product formulation (i.e. Pelleted/Tabletted). | Type in the active ingredient(s) listed on the product label (i.e. Bromadiolone). | Type in the active ingredient percentage listed on the product label (i.e. 0.005). | Type in the amount of concentrate used for mixing. If the product does not require mixing and is ready to be used please select "N/A". | Select the appropriate units of measure related to the amount of concentrate from the drop down list (i.e. ounce, pound, etc.). If the product does not require mixing and is ready to be used please select "N/A". | Type in the Final % Concentration in the Finished Product. If the product does not require mixing and is ready to be used please select "N/A". | Type in the amount of finished product applied. For products that are formulated as Aerosols, please indicate the number of can(s) used. This estimate will be useful in calculating the total Pounds of Active Ingredient (PAI) applied. | Select the appropriate units of measure related to the amount of finished product applied from the drop down list (i.e. ounce, pound, etc.). | Type in the name of the person (i.e. John Doe) who applied the pesticide. | Type in the applicator's DoD FIFRA, DoD Non-FIFRA, or State Certification Number. | Type in the exact time in which the pesticide was applied at the site. The preferred format is hh:mm (i.e. 09:45). | Type in the total time invested by all applicators in the operation in hours (i.e. 1 or 0.5). | For foreign/non-EPA registered products please submit an electronic copy or high resolution photo of the product label. |
| Date | Country | Base Camp | Site of Application | Origin | Operation | Target Pest | Area Treated | Units of Measure for the Area Treated | EPA Registration Number | Pesticide Trade Name | Product Formulation | Active Ingredient | Active Ingredient Percentage | Amount of Concentrate Used for Mixing | Units of Measure for the Amount of Concentrate Used for Mixing | Final % Concentration in Finished Product | Amount of Finished Product Applied | Units of Measure for the Amount of Finished Product Applied | Applicator Name | Applicator Certification # | Time Pesticide was Applied | Total Time Invested in Hours | Additional Comments |
Surv NonChemical Animal Control
| Please complete this worksheet for recording all surveillance, nonchemical, and animal control information. |
| Country |
| POC/Unit: |
| Type in the date that the pesticide was applied. The preferred format is YYYY-MM-DD (i.e. 2020-07-22). | The name of the country where the pesticide was applied should automatically populate based on the selection made in the "Country" cell above. | Select the DOEHRS base camp name from the drop down list below where the pesticide was applied. If the location is not listed, please type in the current name of the base camp. | Select the site of application from the drop down list. If the site of application is not listed, then type in the site of application. The site of application is the specific location (i.e. bldg #, activity name, etc.) for this action. | Please select the origin from the drop down list. An origin is why you did the work: routine inspection, work request, surveillance, etc. | Select an operation from the drop down list. An operation is the type of work done (i.e. light trap, sticky trap, fly trap, caulking). If the operation is not listed, then type in the operation. | Select a target pest from the drop down list that you were attempting to survey or control by a nonchemical measure. If the target pest isn't listed, then write the target pest in the additional comments field. | Select the device name used for surveillance/nonchemical control from the drop down list below (i.e., CDC Light trap, Shannon trap). Type in the device name if not listed in the drop down list. | Type in the number of traps/devices used. | Select the unit of measure (if applicable), otherwise leave it blank. | Type in the size of the area inspected/serviced. It needs to be a number between 0 and 1000000. Use decimals if needed. | Select the appropriate unit of measure (i.e. square feet, meters, acres, etc.) related to the area inspected/serviced from the drop down list. | Type in the name of the person (i.e. applicator) performing the work described. | Type in your DoD FIFRA, DoD Non-FIFRA, or State Certification Number. | Please type in the exact time in which the operation took place at the site. The preferred format is hh:mm (i.e. 09:45). | Type in the total time invested by all applicators in the operation in hours (i.e. 1 or 0.5). | Provide additional comment(s) if needed. |
| Date | Country | Base Camp | Site of Application/Surveillance | Origin | Operation | Target Pest | Surveillance/Nonchemical Device Used | Number of traps/Units placed | Units of Measure | Area Inspected/Serviced | Units of Measure for the Area Inspected/Serviced | Applicator Name | Applicator Certification # | Time of Operation | Total Time Invested in Hours | Additional Comments |
SUMMARY
Data Submission Summary for Deployment Pest Management
| Base Camp: | SM02 | # Pesticide Applications: | Total Time Invested: | |||||
| Dates: | 4/3/20 | - | 4/30/20 | 3 | 19 | hours |
| All Pesticides Applied | Amt Conc/Finished Prod | PESTICIDE DATA | Targeted Pests | Time Invested | |
| FINAL All-Weather Blox | 61.6 | ounce | Rodent | 1.75 hours |
Non-chemical Devices Used Number Used NON PESTICIDE DATA Targeted Pests Time Invested
| N/A | All Pests | 3.75 hours | |
| 1 | Filth Flies | 1.25 hours | |
| Glue Board/Sticky Trap | 22 | N/A | 9 hours |
| Bait Box | 22 | Rodents | 2.5 hours |
| Tin Cat Trap | 4 | Snake | 0.75 hours |
| Fly Relief | 6 | ||
| Fly Bag | 1 |
&8FOR OFFICIAL USE ONLY &8FOR OFFICIAL USE ONLY &8FOR OFFICIAL USE ONLY
&8FOR OFFICIAL USE ONLY &8FOR OFFICIAL USE ONLY &8FOR OFFICIAL USE ONLY
Sheet2 FINAL All-Weather Blox
Sheet3
| N/A |
| 1 |
| Glue Board/Sticky Trap |
| Bait Box |
| Tin Cat Trap |
| Fly Relief |
| Fly Bag |
Sheet4
| All Pests | 0.00 |
| Filth Flies | 0.00 |
| N/A | 0.00 |
| Rodents | 0.00 |
| Snake | 0.00 |
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Sheet5
| Rodent | 0 |
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Example(s)
| Country | Afghanistan |
| POC/Unit: | Jeffrey Cook, DynCorp International |
| Example of Pesticides Applied | |||||||||||||||||||||||
| Type in the date that the pesticide was applied. The preferred format is YYYY-MM-DD (i.e. 2020-07-22). | The name of the country where the pesticide was applied should automatically populate based on the selection made in the "Country" cell above. | Select the DOEHRS base camp name from the drop down list below where the pesticide was applied. If the location is not listed, please type in the current name of the base camp. | Select the specific site of application from the drop down list where the pesticide was applied (i.e. bldg #, activity name, etc.) . If the site is not listed, please type in the site of application. | Select the origin for why the pesticide was applied from the drop down list (i.e. work order, etc.). | Select the type of operation performed from the drop down list (i.e. Exterior Bait). | Select a target pest that you were attempting to manage/control from the drop down list (i.e. Rodents). If the target pest isn't listed, then write the target pest in the additional comments field. | Type in the size of the area treated (i.e. 100). | Select the appropriate units of measure (i.e. square feet, meters, acres, etc.) related to the area treated from the drop down list. | Select the Environmental Protection Agency Registration Number (EPA Reg. No. on product label) of the pesticide applied from the drop down list (i.e. 12455-79). If the number doesn't appear, please go to the worksheet called "New Pesticides Applied" to manually enter the EPA Registration Number. | If the EPA Registration Number is selected, the pesticide trade name will automatically populate in this column (i.e. CONTRAC All-Weather Blox). | If the EPA Registration Number is selected, the product formulation will automatically populate in this column (i.e. Pelleted/Tabletted). | If the EPA Registration Number is selected, the active ingredient percentage for the product will automatically populate in this column (i.e. 0.005). | Type in the amount of concentrate used for mixing. If the product does not require mixing and is ready to be used please select "N/A". | Select the appropriate units of measure related to the amount of concentrate from the drop down list (i.e. ounce, pound, etc.). If the product does not require mixing and is ready to be used please select "N/A". | Type in the Final % Concentration in the Finished Product. If the product does not require mixing and is ready to be used please select "N/A". | Type in the amount of finished product applied. For products that are formulated as Aerosols, please indicate the number of can(s) used. This estimate will be useful in calculating the total Pounds of Active Ingredient (PAI) applied. | Select the appropriate units of measure related to the amount of finished product applied from the drop down list (i.e. ounce, pound, etc.). | Type in the name of the person (i.e. John Doe) who applied the pesticide. | Type in the applicator's DoD FIFRA, DoD Non-FIFRA, or State Certification Number. | Type in the exact time in which the pesticide was applied at the site. The preferred format is hh:mm (i.e. 09:45). | Type in the total time invested by all applicators in the operation in hours (i.e. 1 or 0.5). | Provide any additional comments. | |
| Date | Country | Base Camp | Site of Application | Origin | Operation | Target Pest | Area Treated | Units of Measure for the Area Treated | EPA Registration Number | Pesticide Trade Name | Product Formulation | Active Ingredient Percentage | Amount of Concentrate Used for Mixing | Units of Measure for the Amount of Concentrate Used for Mixing | Final % Concentration in Finished Product | Amount of Finished Product Applied | Units of Measure for the Amount of Finished Product Applied | Applicator Name | Applicator Certification # | Time Pesticide was Applied | Total Time Invested in Hours | Additional Comments | |
| 2020-07-22 | Afghanistan | DAHLKE | Post Exchange (PX) | Work Order | Exterior Bait | Rodents | 780 | linear feet | 12455-79 | CONTRAC All-Weather Blox | Pelleted/Tabletted | 0.005 | N/A | N/A | N/A | 54 | ounce | John Doe | OAE-096-10 | 9:45 | 1 | ||
| 2020-07-22 | Afghanistan | DAHLKE | Barracks | Service or Trouble Call | Interior Residual Treatment | Bed Bugs | 1000 | square feet | 432-1363 | TEMPO SC ULTRA | Soluble Concentrate | 11.8 | 8 | milliliter | 0.025 | 1 | gallon | John Doe | OAE-096-10 | 10:00 | 1 | Headboards and bedframes treated | |
| 2020-07-22 | Afghanistan | DAHLKE | Dining Facility (DFAC) | Scheduled Work | Exterior Bait | Rodents | 200 | linear feet | 12455-89 | FINAL All-Weather Blox | Pelleted/Tabletted | 0.005 | N/A | N/A | N/A | 20 | ounce | Tom Smith | A-310-11-0707 | 10:00 | 0.25 | ||
| 2020-07-23 | Afghanistan | DAHLKE | Hangar B, Building 56 | Service or Trouble Call | Ultra Low Volume Application | Gnats | 12,000 | cubic feet | 499-450 | PT ULD BP-300 Contact Insecticide Formula 1 | ULV Concentrate | 19 | 3 | fluid ounce | 1 | 12 | fluid ounce | Tom Smith | A-310-11-0707 | 13:00 | 1 | ||
| 2020-07-23 | Afghanistan | DAHLKE | Building 107, COMM Center | Scheduled Work | Interior Bait | Ants | 200 | square feet | 432-1252 | Maxforce Ant Bait Stations | Impregnated Material | 1 | N/A | N/A | N/A | 6 | each | John Doe | OAE-096-10 | 13:00 | 0.1 | ||
| 2020-07-24 | Afghanistan | DAHLKE | Zone 18, Building 101 | Work Order | Exterior Residual Or Spot Treatment | Wasps | 10 | square feet | 499-362 | PT Wasp-Freeze Wasp & Hornet Killer | Aerosol | 0.249 | N/A | N/A | N/A | 6 | second | Tom Smith | A-310-11-0707 | 9:30 | 0.15 | ||
| 2020-07-24 | Afghanistan | DAHLKE | Building 57, Latrines | Scheduled Work | Exterior Bait | Filth Flies | 700 | square feet | 432-1375 | Maxforce Granular Fly Bait | Granular | 0.6 | N/A | N/A | N/A | 4 | ounce | Tom Smith | A-310-11-0707 | 10:00 | 0.5 | ||
| 2020-07-24 | Afghanistan | DAHLKE | Ammunition Bunker | Work Order | Sprayed By Hand | Weeds | 1 | acre | 524-475 | Roundup Pro Herbicide | Soluble Concentrate | 41 | 1 | quart | 1 | 25 | gallon | Tom Smith | A-310-11-0707 | 14:00 | 2 | Needed for security to inspect perimiter | |
| Example of New Pesticides Applied | |||||||||||||||||||||||
| Type in the date that the pesticide was applied. The preferred format is YYYY-MM-DD (i.e. 2020-07-22). | The name of the country where the pesticide was applied should automatically populate based on the selection made in the "Country" cell above. | Select the DOEHRS base camp name from the drop down list below where the pesticide was applied. If the location is not listed, please type in the current name of the base camp. | Select the specific site of application from the drop down list where the pesticide was applied (i.e. bldg #, activity name, etc.) . If the site is not listed, please type in the site of application. | Select the origin for why the pesticide was applied from the drop down list (i.e. work order, etc.). | Select the type of operation performed from the drop down list (i.e. Exterior Bait). | Select a target pest that you were attempting to manage/control from the drop down list (i.e. Rodents). If the target pest isn't listed, then write the target pest in the additional comments field. | Type in the size of the area treated (i.e. 100). | Select the appropriate units of measure (i.e. square feet, meters, acres, etc.) related to the area treated from the drop down list. | Type in the Environmental Protection Agency Registration Number (EPA Reg. No. on product label) of the pesticide applied (i.e. 12455-79). | Type in the pesticide trade name (i.e. CONTRAC All-Weather Blox). | Type in the product formulation (i.e. Pelleted/Tabletted). | Type in the active ingredient(s) listed on the product label (i.e. Bromadiolone). | Type in the active ingredient percentage listed on the product label (i.e. 0.005). | Type in the amount of concentrate used for mixing. If the product does not require mixing and is ready to be used please select "N/A". | Select the appropriate units of measure related to the amount of concentrate from the drop down list (i.e. ounce, pound, etc.). If the product does not require mixing and is ready to be used please select "N/A". | Type in the Final % Concentration in the Finished Product. If the product does not require mixing and is ready to be used please select "N/A". | Type in the amount of finished product applied. For products that are formulated as Aerosols, please indicate the number of can(s) used. This estimate will be useful in calculating the total Pounds of Active Ingredient (PAI) applied. | Select the appropriate units of measure related to the amount of finished product applied from the drop down list (i.e. ounce, pound, etc.). | Type in the name of the person (i.e. John Doe) who applied the pesticide. | Type in the applicator's DoD FIFRA, DoD Non-FIFRA, or State Certification Number. | Type in the exact time in which the pesticide was applied at the site. The preferred format is hh:mm (i.e. 09:45). | Type in the total time invested by all applicators in the operation in hours (i.e. 1 or 0.5). | For foreign/non-EPA registered products please submit an electronic copy or high resolution photo of the product label. |
| Date | Country | Base Camp | Site of Application | Origin | Operation | Target Pest | Area Treated | Units of Measure for the Area Treated | EPA Registration Number | Pesticide Trade Name | Product Formulation | Active Ingredient | Active Ingredient Percentage | Amount of Concentrate Used for Mixing | Units of Measure for the Amount of Concentrate Used for Mixing | Final % Concentration in Finished Product | Amount of Finished Product Applied | Units of Measure for the Amount of Finished Product Applied | Applicator Name | Applicator Certification # | Time Pesticide was Applied | Total Time Invested in Hours | Additional Comments |
| 2020-07-24 | Afghanistan | DAHLKE | Dining Facility (DFAC) | Service or Trouble Call | Interior Bait | Cockroaches | 100 | linear feet | 352-668 | DuPont Advion Cockroach Bait Arena | Bait Station | Indoxacarb | 0.5 | N/A | N/A | N/A | 5 | each | Tom Smith | A-310-11-0707 | 16:15 | 0.25 | Used to combat cockroaches resistant to hydramethylnon |
| Example of Surveillance, Non-Chemical, and Animal Control | ||||||||||||||||
| Type in the date that the pesticide was applied. The preferred format is YYYY-MM-DD (i.e. 2020-07-22). | The name of the country where the pesticide was applied should automatically populate based on the selection made in the "Country" cell above. | Select the DOEHRS base camp name from the drop down list below where the pesticide was applied. If the location is not listed, please type in the current name of the base camp. | Select the site of application from the drop down list. If the site of application is not listed, then type in the site of application. The site of application is the specific location (i.e. bldg #, activity name, etc.) for this action. | Please select the origin from the drop down list. An origin is why you did the work: routine inspection, work request, surveillance, etc. | Select an operation from the drop down list. An operation is the type of work done (i.e. light trap, sticky trap, fly trap, caulking). If the operation is not listed, then type in the operation. | Select a target pest from the drop down list that you were attempting to survey or control by a nonchemical measure. If the target pest isn't listed, then write the target pest in the additional comments field. | Select the device name used for surveillance/nonchemical control from the drop down list below (i.e., CDC Light trap, Shannon trap). Type in the device name if not listed in the drop down list. | Type in the number of traps/devices used. | Select the unit of measure (if applicable), otherwise leave it blank. | Type in the size of the area inspected/serviced. It needs to be a number between 0 and 1000000. Use decimals if needed. | Select the appropriate unit of measure (i.e. square feet, meters, acres, etc.) related to the area inspected/serviced from the drop down list. | Type in the name of the person (i.e. applicator) performing the work described. | Type in the applicator's DoD FIFRA, DoD Non-FIFRA, or State Certification Number. | Please type in the exact time in which the operation took place at the site. The preferred format is hh:mm (i.e. 09:45) | Type in the total time invested by all applicators in the operation in hours (i.e. 1 or 0.5). | Provide additional comment(s) if needed. |
| Date | Country | Base Camp | Site of Application/Surveillance | Origin | Operation | Target Pest | Surveillance/Nonchemical Device Used | Number of traps/Units placed | Units of Measure | Area Inspected/Serviced | Units of Measure for the Area Inspected/Serviced | Applicator Name | Applicator Certification # | Time of Operation | Total Time Invested in Hours | Additional Comments |
| 2020-07-22 | Afghanistan | DAHLKE | Dining Facility (DFAC) | Work Request | Trapping | Rodent | Glue Board/Sticky Trap | 2 | EA | 80 | square feet | Miller, Glen | AF-001-10-0198 | 8:45 | 0.1 | |
| 2020-07-22 | Afghanistan | DAHLKE | Area 3 | Routine Inspection | Pest Surveillance | All Pests | Visual Surveillance | N/A | N/A | 780 | square feet | Miller, Glen | AF-001-10-0198 | 16:10 | 1 | Lots of scorpions present |
| 2020-07-22 | Afghanistan | DAHLKE | AMPM | Work Request | Trapping | Cats | Animal Trap | 2 | EA | 4555 | square feet | Miller, Glen | AF-001-10-0198 | 9:45 | 0.3 | |
| 2020-07-23 | Afghanistan | DAHLKE | Dining Facility (DFAC) | Work Request | Trapping | Filth Flies | Glue Board/Sticky Trap | 1 | EA | 2 | acre | Cook, Richard | PA-704174 | 17:35 | 0.2 | |
| 2020-07-23 | Afghanistan | DAHLKE | Area 2 | Work Request | Fly Bag Trap | Filth Flies | Fly Relief | 2 | EA | 5 | hectare | Cook, Richard | PA-704174 | 13:15 | 0.75 |
Pesticides to Add
| AIPH will maintain this worksheet by filling in any "new" pesticides that may need added to DOEHRS | ||||||
| EPA Registration Number | Pesticide Name (i.e. trade name) | Source | Active Ingredient Percent | PAI Weight | Product Formulation | Notes |
PesticidesApplied PAI
| Date (YYYY-MM-DD) | Country | Base Camp | Site of Application | Origin | Operation | Target Pest | Area Inspected/Treated | Area Units of Measure | Applicator Name | Total Time Invested | Time Pesticide Applied (hh:mm) | EPA Registration Number | Pesticide Name | Product Formulation | Amount of Concentrate Applied | Amount of Concentrate Applied Units of Measure | Amount of Finished Product | Amount of Finished Product Units of Measure | Additional Comments | Total PAI |
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This is the start of the file's text. The full file is on GovTribe.
File details come from the government source that posted it. Updated .