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Harvester Termites Questionnaire

Harvester Termite Inspection Survey

    Date of Treatment:
    Province: (Please Select)

    City:
    Suburb:
    Was the treatment you did, a retreatment or first treatment? (Please Select)
    If you did a retreatment, how many weeks has it been since the previous treatment done?:

    Area of infestation: (Please Select)

    Estimation of total area (m2) of infestation inside:
    Estimation of total area (m2) of infestation outside:
    Type of treatment used:
    Type of Harvester Termite: (Please Select)
    Type of application: (Please Select)
    Comments:
    Name:

    Surname:

    Company Name placeholder:

    Address:

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