TE__3_Pest_Management_Rec_24_May_18.pdf

Technical Exhibit No. 3

Pest Management Maintenance Record

BUILDING/AREA

SIZE

TYPE OF

CONSTRUCTION

USE DESIGNATION

Date Units

Serviced Work Origin

Unit of Measure

Target Pest

Control Operation

If Pesticide is Used Labor Time

Appli-cator

Initials Name EPA Reg % Conc Amount

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

MEASUREMENT UNITS ORIGIN OF WORK TYPE OF CONSTRUCTION

MSF = 1,000 square feet LFF = Linear feet SW = Scheduled work SC = Service or trouble call CO = Concrete BV = Brick veneer WO = Wood

MCF - 1,000 cubic feet AC = Acres WR = Work request R = Routine inspection BL = Block ST = Steel, sheet metal OT = Other

DD FORM 1532-1, AUG 96

W912CN-18-R-0018

Date Units

Serviced Work Origin Unit of

Measure Target Pest Control

Operation If Pesticide is Used Labor

Time Appli-cator

Initials Name EPA Reg % Conc Amount

REMARKS

DD FORM 1532-1 (BACK), AUG 96 (Attach additional card to continue record)