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    Service Report Berita Acara: A. Customer Information

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    keslingunimedika sepatan
    The service report documents a pest control treatment at RS Sepatan Mulia hospital in Tangerang, Banten, Indonesia, where various pests including flies, mosquitoes, and other flying insects were found at low levels. Multiple pesticides were applied including brodifacoum bait, imidacloprid spray, and cypermethrin fogging. Recommendations were made to improve monitoring devices and reduce clutter providing shelter for pests.

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    Service Report Berita Acara: A. Customer Information

    Uploaded by

    keslingunimedika sepatan
    33 views3 pages
    The service report documents a pest control treatment at RS Sepatan Mulia hospital in Tangerang, Banten, Indonesia, where various pests including flies, mosquitoes, and other flying insects were found at low levels. Multiple pesticides were applied including brodifacoum bait, imidacloprid spray, and cypermethrin fogging. Recommendations were made to improve monitoring devices and reduce clutter providing shelter for pests.

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    10.03.23

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    The service report documents a pest control treatment at RS Sepatan Mulia hospital in Tangerang, Banten, Indonesia, where various pests including flies, mosquitoes, and other flying insects were found at low levels. Multiple pesticides were applied including brodifacoum bait, imidacloprid spray, and cypermethrin fogging. Recommendations were made to improve monitoring devices and reduce clutter providing shelter for pests.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    33 views3 pages

    Service Report Berita Acara: A. Customer Information

    Uploaded by

    keslingunimedika sepatan
    The service report documents a pest control treatment at RS Sepatan Mulia hospital in Tangerang, Banten, Indonesia, where various pests including flies, mosquitoes, and other flying insects were found at low levels. Multiple pesticides were applied including brodifacoum bait, imidacloprid spray, and cypermethrin fogging. Recommendations were made to improve monitoring devices and reduce clutter providing shelter for pests.

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    Service 

    Report
    Berita Acara
    Report to Customer
    Rentokil Indonesia (RI-JK-OS-230-SE-F-8.5-06)
    Ref:142143_20230310183853
    A. CUSTOMER INFORMATION
    Purpose of Treatment Routine Shared Type of Premise Hospitals
    Account Number 700022169 Type of Pests Covered Qty Freq
    Contract Number 50051177/1 General Pest Plus
    : Ants - Other, Cockroaches - Other, Flies, Mosquito, Rodents 0 48
    Type of Premise Hospitals (GPP)
    Customer Name RS SEPATAN MULIA Cat Control
    0 48
    Contact Name IBU NOVA : (CATC)
    Fogging (Oil Based)
    Contact Number +622159371801 0 48
    : (FOG)
    Address (Site of application) RS SEPATAN MULIA
    JL. RAYA PAKUHAJI RT 02 RW
    01
    SEPATAN
    TANGERANG
    BANTEN
    15520
    Site Risk Assessment
    Terdapat Anak-anak/Orang Tua/Orang Cacat/Keramaian : AREA DALAM Terdapat kendaraan/forklift/mesin pengangkat : PARKIR Bahan kimia/gas/debu/uap
    : AREA LUAR, AREA DALAM Mengangkat/mengangkut : AREA LUAR, AREA DALAM Adanya penghisap udara pada sistem ventilasi : AREA DALAM

    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:

    FIKRI BAMBANG IRAWAN


    Name Name bp ahmad ridwan
    FIKRI BAMBANG IRAWAN
    License No. Date 10-03-2023 13:56
    Date 10-03-2023 13:56
    Time In 13:56
    Time Out 18:38
    Name of other Applicators: DEBY ISWANTO DEBY ISWANTO

    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

    Brodifacoum Talon 0.005 BB (GPP) Baiting 120 gram


    Area Pesticide Applied

    Luminos 1 Glue 011 (GPP) Monitoring / Trapping 9 Unit


    Area Pesticide Applied

    Trigonal Box (GPP) Monitoring / Trapping 6 Unit


    Area Pesticide Applied

    Lem Tikus Tube (GPP) Monitoring / Trapping 4 Tube

    1/3
    Area Pesticide Applied

    Cypermethrin Smash 100EC (GPP) Cold fogging 100 ml


    Area Pesticide Applied

    Imidacloprid QuickBayt Spray 10 WG (GPP) Spraying 100 g


    Area Pesticide Applied

    Cypermethrin Smash 100EC (FOG) Thermal fogging 100 ml


    Area Pesticide Applied

    Brodifacoum Talon 0.005 BB (GPP) Baiting 8 gram


    Area Pesticide Applied

    Brodifacoum Talon 0.005 BB (GPP) Baiting 8 gram


    Area Pesticide Applied

    Lem Tikus Tube (GPP) Monitoring / Trapping 0.25 Tube


    Area Pesticide Applied

    Lem Tikus Tube (GPP) Monitoring / Trapping 0.25 Tube


    Area Pesticide Applied

    Luminos 1 Glue 011 (GPP) Monitoring / Trapping 1 Unit


    Area Pesticide Applied

    Luminos 1 Glue 011 (GPP) Monitoring / Trapping 1 Unit


    Area Pesticide Applied

    Luminos 1 Glue 011 (GPP) Monitoring / Trapping 1 Unit


    Area Pesticide Applied

    Luminos 1 Glue 011 (GPP) Monitoring / Trapping 1 Unit


    Area Pesticide Applied

    Luminos 1 Glue 011 (GPP) Monitoring / Trapping 1 Unit


    Area Pesticide Applied

    Luminos 1 Glue 011 (GPP) Monitoring / Trapping 1 Unit


    Area Pesticide Applied

    Imidacloprid QuickBayt Spray 10 WG (GPP) Spraying 100 g


    Area Pesticide Applied

    Cypermethrin Smash 100EC (GPP) Thermal fogging 100 ml


    Area Pesticide Applied

    Cypermethrin Smash 100EC (GPP) Cold fogging 200 ml


    Area Pesticide Applied

    E. PEST STATUS
    Pest Level Location Found Remarks

    Flying Insect Other Low - 7 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 2 LUMNIA

    Mosquito Low - 2 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 2 LUMNIA

    Flying Insect Other Low - 16 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 6 LUMNIA

    Houseflies Low - 2 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 6 LUMNIA

    Mosquito Low - 10 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 6 LUMNIA

    Flying Insect Other Low - 17 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 5 LUMNIA

    Houseflies Low - 4 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 5 LUMNIA

    Mosquito Low - 11 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 5 LUMNIA
    2/3
    Flying Insect Other Low - 19 Internal
    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 4 LUMNIA

    Houseflies Low - 5 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 4 LUMNIA

    Mosquito Low - 13 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 4 LUMNIA

    Flying Insect Other Low - 10 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 1 LUMNIA

    Mosquito Low - 6 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 1 LUMNIA

    Flying Insect Other Low - 7 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 3 LUMNIA

    Mosquito Low - 4 Internal


    Building: RS SEPATAN MULIA, Floor: 1st Floor, Zone: 3rd Line Office, Location Found: I4. 3 LUMNIA

    F. RECOMMENDATIONS BY RENTOKIL INITIAL
    Type Recommendations Priority

    QA Recommendations (GPP) pergantian unit monitoring prisma segitiga ke unit monitoring trigonal box Low
    (GPP) Tumpukkan barang yang diletakkan dekat dengan bangunan akan dijadikan sebagai sarang oleh hama,
    Stacking Low
    pastikan untuk meniadakan tumpukkan barang tersebut atau direlokasi jauh dari bangunan.

    G. SERVICE VISIT NOTES
    Product (s) Visit Notes

    Cat Control - 48

    Fogging (Oil Based) - 48

    General Pest Plus - 48

    Rentokil Indonesia Komplek Pergudangan Multiguna, Duta Indah Iconic, Blok C No.37, Jl. M H Thamrin, Cikokol, Tangerang, 15117
    t +622129866707/706 f e rendra.wdriyo@rentokil-initial.com w www.rentokil.co.id p myRentokil

    3/3

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