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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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