Professional Documents
Culture Documents
Report
Berita Acara
Report to Customer
Rentokil Indonesia (RI-JK-OS-230-SE-F-8.5-06)
Ref:AQ6270_20220903135022
A. CUSTOMER INFORMATION
Purpose of Treatment Routine Type of Premise Hospitals
Account Number 517000322 Type of Pests Covered Qty Freq
Contract Number 51700106/1 General Pest
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: Rodents (PESTS)
Type of Premise Hospitals
Customer Name Yay.Rumah Sakit Bethesda Tomohon
Contact Name Bpk Gafri Bofi Kasenda
Contact Number +6285240408481
Address (Site of Yay.Rumah Sakit Bethesda Tomohon
application) Jl.Raya Tomohon Selatan-Tomohon Selatan
Tomohon
Sulawesi Utara
Kota Tomohon
Indonesia
95439
Site Risk Assessment
ORANG LALU LALANG/ANAK-ANAK/ORANG TUA Terdapat Anak-anak/Orang Tua/Orang Cacat/Keramaian Dekat dengan instalasi listrik
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:
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
(%))
Rodent Bait Station (PESTS) Baiting 3 50 unit
Area gedung maria,gedung markus,gedung elizabeth,gedung hemodializa,gedung OK,gedung paulus,gedung instalasi
Area Pesticide Applied
gizi,area taman,area depan.
E. PEST STATUS
Pest Level Location Found Remarks
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F. RECOMMENDATIONS BY RENTOKIL INITIAL
Type Recommendations Priority
Other (PESTS) Sesuai dengan hasil inspeksi, sudah dipastikan tidak ada hama di area ini Low
G. SERVICE VISIT NOTES
Product (s) Visit Notes
Rentokil Indonesia L.Sam Ratulangi No.199 B, Kel.Titiwungen Selatan, Kec. Sario, Manado, Sulawesi Utara, 95113
t 431-8806650 f e w www.rentokil.co.id
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