Service Report

Report to Customer

Rentokil Indonesia (RI-JK-TD-72-SE-F-8.5.1-51)

Ref:152893_20190221194913
A. CUSTOMER INFORMATION
Purpose of Treatment Call Out Type of Premise Medical
Account Number 700014314 Type of Pests Covered Qty Freq
Contract Number 50033326/1 General Pest Plus
: Ants - Other, Cokcroaches - Other, Flies, Mosquito, Rodents 0 24
Type of Premise Medical (GPP)
Customer Name PT. CKD OTTO PHARMACEUTICALS Luminos 1 White
10 24
Contact Name BAPAK ZEREMIA SAMOSIR : (L1W)

Contact Number +62215264943
Address (Site of application) PT. CKD OTTO PHARMACEUTICALS
DELTA SILICON 3, JL KAPUK TIMUR
F23
NO 17, CICAU, CIKARANG PUSAT
BEKASI
INDONESIA
17530
Site Risk Assessment
Terdapat Anak-anak/Orang Tua/Orang Cacat/Keramaian Terdapat Hewan Peliharaan/Ternak/Binatang/Hama Terdapat kendaraan/forklift/mesin pengangkat
Banyak anak tangga/permukaan tidak aman

B. APPLICATOR’S INFORMATION C. CUSTOMER’S SIGNATURE
I declare the information below is true and correct: I acknowledge receipt of the report below:
Signature: Signature:
DEDEN WANTO DEDEN zeremia
Name Name
WANTO samosir
21-02-2019
License No. Date
15:32:40
Date 21-02-2019 15:32:40

Time In 15:32:40 Time Out 19:49:12

Name of other Applicators:

D. PESTICIDES APPLIED
Active Ingredient Trade Name Class Method of Total Total
(Conc. Diluted Solution Applied (Conc. Diluted Solution Applied (%)) Application Area Qty
(%)) Treated Used
Monitoring /
Lem Tikus Tube (GPP) 0.5 Tube
Trapping
Area Pesticide Applied Area taman belakang

Monitoring /
Luminos 1 Glue 012 (GPP) 10 Unit
Trapping
Area Pesticide Applied Area dalam bangunan

Brodifacoum Talon 0.005 BB (GPP) Baiting 156 g

Area Pesticide Applied Area luar bangunan (Ring 1 dan 2)

Cypermethrin Smash 100EC (GPP) Cold fogging 30 ml

Area Pesticide Applied Area lobby
Monitoring /
Lem Tikus Tube (GPP) 6 Tube
Trapping
Area Pesticide Applied Area dalam bangunan
Monitoring /
Luminos 1 Glue 011 (GPP) 10 Unit
Trapping
Area Pesticide Applied Area dalam bangunan

F. RECOMMENDATIONS BY RENTOKIL INITIAL
Type Recommendations Priority
(GPP) Genangan air diarea koridor gudang dapat menjadi tempat infestasi
Housekeeping Medium
hama
G. SERVICE VISIT NOTES
Product (s) Visit Notes

General Pest Plus - 24

Luminos 1 White - 24

Rentokil Indonesia Cikarang Central City Blok H11-H12, Jalan Cibarusah KM. 10, Cikarang Selatan, Bekasi, 17530
t +622129619127 f +622129619127 e witri.widyastuti@rentokil-initial.com w www.rentokil.co.id