W911SA-22-Q-3064 Attachment 11 DD Form 1532-1 Pest Management Maintenance Record.docx

ATTACHMENT 11

DD FORM 1532-1 PEST MANAGEMENT MAINTENANCE RECORD

image1.emf

BUILDING/AREA SIZE

TYPE OF

CONSTRUCTION USE DESIGNATION

Date Units Serviced

Work Origin

Unit of Measure

Target Pest

Control Operation

If Pesticide is Used

Name EPA Reg % Conc Amount Labor Time

Appli-cator Initials

Form Approved. OMB No. 0704-0188 REPORT CONTROL SYMBOL: PEST MANAGEMENT MAINTENANCE RECORD

DD FORM 1532-1, AUG 96

MEASUREMENT UNITS

MSF = 1,000 square feet MCF - 1,000 cubic feet

LFF = Linear feet AC = Acres

ORIGIN OF WORK

SW = Scheduled work WR = Work request

TYPE OF CONSTRUCTION

CO = Concrete BL = Block

BV = Brick veneer ST = Steel, sheet metal

SC = Service or trouble call R = Routine inspection

WO = Wood OT = Other

The public reporting burden for this collection of information is estimated to average 4 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION.

Date Units Serviced

Work Origin

Unit of Measure

Target Pest

Control Operation

If Pesticide is Used

Name EPA Reg % Conc Amount Labor Time

Appli-cator Initials

DD FORM 1532-1 (BACK), AUG 96

REMARKS

(Attach additional card to continue record) date6:

unitsvc6:

origin6:

unitmeas6:

pest6:

ctrlop6:

pesticide6:

epareg6:

pct6:

amount6:

labor6:

appinit6:

date7:

unitsvc7:

origin7:

unitmeas7:

pest7:

ctrlop7:

pesticide7:

epareg7:

pct7:

amount7:

labor7:

appinit7:

date8:

unitsvc8:

origin8:

unitmeas8:

pest8:

ctrlop8:

pesticide8:

epareg8:

pct8:

amount8:

labor8:

appinit8:

date1:

unitsvc1:

origin1:

unitmeas1:

pest1:

ctrlop1:

pesticide1:

epareg1:

pct1:

amount1:

labor1:

appinit1:

date9:

unitsvc9:

origin9:

unitmeas9:

pest9:

ctrlop9:

pesticide9:

epareg9:

pct9:

amount9:

labor9:

appinit9:

date10:

unitsvc10:

origin10:

unitmeas10:

pest10:

ctrlop10:

pesticide10:

epareg10:

pct10:

amount10:

labor10:

appinit10:

date11:

unitsvc11:

origin11:

unitmeas11:

pest11:

ctrlop11:

pesticide11:

epareg11:

pct11:

amount11:

labor11:

appinit11:

date2:

unitsvc2:

origin2:

unitmeas2:

pest2:

ctrlop2:

pesticide2:

epareg2:

pct2:

amount2:

labor2:

appinit2:

date3:

unitsvc3:

origin3:

unitmeas3:

pest3:

ctrlop3:

pesticide3:

epareg3:

pct3:

amount3:

labor3:

appinit3:

date4:

unitsvc4:

origin4:

unitmeas4:

pest4:

ctrlop4:

pesticide4:

epareg4:

pct4:

amount4:

labor4:

appinit4:

date5:

unitsvc5:

origin5:

unitmeas5:

pest5:

ctrlop5:

pesticide5:

epareg5:

pct5:

amount5:

labor5:

appinit5:

date12:

date13:

date14:

date15:

unitsvc12:

unitsvc13:

unitsvc14:

unitsvc15:

origin12:

origin13:

origin14:

origin15:

unitmeas12:

unitmeas13:

unitmeas14:

unitmeas15:

pest12:

pest13:

pest14:

pest15:

ctrlop12:

ctrlop13:

ctrlop14:

ctrlop15:

pesticide12:

pesticide13:

pesticide14:

pesticide15:

epareg12:

epareg13:

epareg14:

epareg15:

pct12:

pct13:

pct14:

pct15:

amount12:

amount13:

amount14:

amount15:

labor12:

labor13:

labor14:

labor15:

appinit12:

appinit13:

appinit14:

appinit15:

remarks:

Reset:

bldg_area:

size:

type_constr:

use_desig:

appl: Adobe Professional 7.0