Pennsylvania pest control service report template

Set up for Pennsylvania

• Each record gives the names and certification or technician registration numbers of everyone making or supervising the application, and the names of any noncertified or nonregistered persons involved7 Pa. Code 128.35 (a) (7)
• Each record gives the date of application and the name and address of the customer, with the address and location of the site if different7 Pa. Code 128.35 (a) (1), (2)

Also required in Pennsylvania

These rules are about how and when you report, not the template's fields. Check them before you deliver.

• For every pesticide, the record gives the brand name, the EPA product registration number, the total amount used in pounds, ounces, gallons or liters, and the dosage or rate of application7 Pa. Code 128.35 (a) (3) to (6)
• For a pesticide with a reentry time, the date of application includes the hour the application was completed7 Pa. Code 128.35 (a) (1)
• The record is completed in written or printable form no later than 24 hours after the application, kept at least 3 years, and made immediately available to the Department on request; product and application information goes immediately to medical personnel in an emergency7 Pa. Code 128.35 (c) to (e)
• Before a commercial application, everyone on the Department's pesticide hypersensitivity registry whose residence or listed location property line is within 500 feet of the site is notified 12 to 72 hours ahead (by phone, in person, certified mail, email or fax, or a note on the door after two phone attempts) with the date, site, time window of no more than 24 hours, products, EPA numbers and active ingredients, and the business's name, phone and license number; bait stations, detached structures not listed, below-soil and tree injections, disinfectants and pool care are exempt; the notification record is made within 24 hours and kept 3 years7 Pa. Code 128.112
• A certified applicator is responsible for those working under their supervision, instructs them in the application method, visits the site routinely to evaluate their work, and is physically present when the label requires7 Pa. Code 128.105
• A specific-site application of a restricted use pesticide needs prior constructive notification to a resident of every dwelling on contiguous land, with the date, time and products at least 12 hours ahead for neighbors who asked 7 days before; applications inside a detached structure, in tamper-resistant bait trays or burrows, below the soil surface (unless near a well or with a fumigant) or injected into trees are exempt7 Pa. Code 128.82

What is in it

• Products appliedProduct, EPA Reg. No., Active ingredient, Amount, Dilution or rate, Method, Where applied
• Pest activity and conditions: insidePest activity seen inside, Sanitation and food or water sources, Leaks and moisture, Clutter and harborage
• Pest activity and conditions: outsidePest activity seen outside, Entry points: gaps, door sweeps, vents and utility openings, Vegetation, mulch and firewood against the structure, Drainage, gutters and standing water
• Monitoring and bait devicesRodent bait stations (secured and tamper-resistant), Traps and glue boards, Insect monitors, Termite monitoring stations
• Service performedWhat was inspected and treated, and how: areas serviced, devices checked, replaced or added, and any exclusion work done.
• Precautions given to the customerWhat the customer was told to do or avoid after the treatment, such as keeping people and pets off treated areas until dry.
• Next stepsThe next service, any callback, and what the customer agreed to do.

Rules last reviewed October 14, 2026. Read the full Pennsylvania pest control service report requirements.