APPENDIX V REPORT ON INSPECTION OF THE PREMISES OF THE PEST CONTROL AGENCY 1 Name & Designation of officers : _________________________________________ who

o conducted the Inspection : _________________________________________ : _________________________________________ : _________________________________________ : ________________________________________

2. Date of Inspection 3. Place of Inspection 4. Name and address of the firm ppl!ing for recognition ". Name of the person authori#ed $to %e authori#ed %! PP for super&ising the 'umigation operations with (eference No.

). Name of the fumigant for which : _________________________________________ pplication has %een made *. +erification of technical e,pertise : -educational .ualifications$ /raining etc.0 supported %! ppropriate documentar! e&idence 1. +erification of e.uipments -As per Appendix-VI0 : 1.1. 2ist out the essential e.uipment or ph!sical facilities not possessed %! the firm for the 3o%: 4.No. Name of the 5.uipment Purpose

6. Is the team satisfied with the : 7es$No Ph!sical facilities a&aila%le with the firm for the 3o%8 If it is 9No: state the deficiencies. 1;. (ecommendations inspection : team of the

11. Name & 4ignature of team mem%ers with date: 1.____________________________________ 2. ____________________________________

ANNEXURES TO INSEPCTION TEAM REPORT APPENDIX-V! Annex"re I Particulars of technical e,pertise -educational .ualifications$training etc.0 supported %! appropriate documentar! e&idence. 4.No. Particulars 1. Name of 5,pert 2. 3. 5ducational <ualifications Institute from where %asic training on fumigation ac.uired. (eference No. & date of appro&al of e,pertise %! Dte. of PP<&4= if an!.

4.

Annex"re # 2ist of e.uipments &erified 4. N o Name of the e.uipment >a?e 4pecifications $ I4I mar?= if an! No. o f possessed the firm @nits Aor?ing condition %! as assessed %! the Inspection /eam including cali%ration as applica%le