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ServiceReceipt 2

Pest control

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Steffy Agustin
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18 views2 pages

ServiceReceipt 2

Pest control

Uploaded by

Steffy Agustin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Service Report

Berita Acara
Report to Customer
Rentokil Indonesia (RI-JK-OS-230-SE-F-8.5-06)
Ref:565309_20241113115816
A. CUSTOMER INFORMATION
Purpose of Treatment Routine Type of Premise Food and Beverage Manufacturer
Account Number 506000030 Type of Pests Covered Qty Freq
Contract Number 50600072/1 General Pest Plus
0 48
: American Cokcroaches, Houseflies, Mosquito, Rodents (GPP)
Type of Premise Food and Beverage Manufacturer
Customer Name PT Siger Jaya Abadi
Contact Name Ibu Steffy
Contact Number +6282280077752
Address (Site of PT Siger Jaya Abadi
application) Jl Raya Tanjung Bintang No 99 Rt 01 Rw 001
Serdang Tanjung Bintang Lampung
Kab. Lampung Selatan
Indonesia
35361
Site Risk Assessment
Terdapat lalulintas orang terdapat kendaraan Bahan Beracun Berbahaya kabel & panel listrik gas mudah terbakar mesin berputar

B. APPLICATOR’S INFORMATION C. CUSTOMER’S SIGNATURE/COMPANY STAMP


I declare the information below is true and
I acknowledge receipt of the report below:
correct:
Signature: Signature:

Ferry Fedrian Rohmadoni Ferry


Name Name stefy
Fedrian Rohmadoni
License No. Date 13-11-2024 11:04
Date 13-11-2024 11:04
Time In 11:04
Time Out 11:58
Name of other Applicators:

D. PESTICIDES APPLIED
Active Ingredient Trade Name Class Method of Total Area Total
(Conc. Diluted Solution Applied (%)) (Conc. Diluted Solution Applied (%)) Application Treated Qty Used
Agita 10 WG,400 G/2.6 L Air,SP,(flies) (GPP) Baiting 200 gram
Area Pesticide Applied Arew wwtp,receving Tiamekoksam 200gr/ 1,3 liter air

Lem Tikus Tube (GPP) Monitoring / Trapping 1 Tube


Area Pesticide Applied Pergantian glue stik di area luar

Brodifacoum Talon 0.005 BB (GPP) Baiting 312 gram


Area Pesticide Applied Area luar bangunan Brodifacoum 312gr/ 39 rbs

Lem Tikus Tube (GPP) Monitoring / Trapping 1 Tube


Area Pesticide Applied Area loker dan workshop

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G. SERVICE VISIT NOTES
Product (s) Visit Notes

General Pest Plus - 48

Rentokil Indonesia Jl. Pangeran Tirtayasa, Komplek Ruko Tirtayasa Center Blok A 6-7, Sukabumi, Bandar Lampung, 35134
t- f e [email protected] w www.rentokil.co.id p myRentokil

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