Form L-10 "Pest Proofing/Repairs Needed Inside" - California

What Is Form L-10?

This is a legal form that was released by the California Department of Pesticide Regulation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • The latest edition provided by the California Department of Pesticide Regulation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form L-10 by clicking the link below or browse more documents and templates provided by the California Department of Pesticide Regulation.

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Download Form L-10 "Pest Proofing/Repairs Needed Inside" - California

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Pest Proofing/Repairs Needed Inside
Date _________________________________ Inspector ______________________________
Facilities Manager ______________________________________________________________
Building#/Location/Address ______________________________________________________
For each repair, specify location and action needed. Draw a floor plan on the reverse side of this form to
clarify locations. State priority for each work item.
Seal holes in wall around pipes, cables, and wires
Seal cracks and crevice with caulk or paint
Seal other holes 1/4" or larger
Fix leaky plumbing
Doors
❒ Repair
❒ Replace
❒ Weather-strip
❒ Add kickplate
Other ________________________________________________________
❒ Correct excessive moisture problems
❒ Remove clutter
❒ Organize storage rooms/closets
❒ Store rodent nesting material (fabric, paper, rug scraps, plastic, insulation) in rodent-proof
containers
❒ Clean drains
❒ Screen drains
❒ Cap drains in basement floors
❒ Store human and pet food in pest-proof containers
❒ Improve sanitation
❒ Dispose of insect- or rodent-infested goods
❒ Remove fecal matter (rodents, bats, birds)
❒ Sanitize animal droppings
❒ Investigate secondary pest potential from rodent infestation (e.g. fleas, mites)
L-10
Pest Proofing/Repairs Needed Inside
Date _________________________________ Inspector ______________________________
Facilities Manager ______________________________________________________________
Building#/Location/Address ______________________________________________________
For each repair, specify location and action needed. Draw a floor plan on the reverse side of this form to
clarify locations. State priority for each work item.
Seal holes in wall around pipes, cables, and wires
Seal cracks and crevice with caulk or paint
Seal other holes 1/4" or larger
Fix leaky plumbing
Doors
❒ Repair
❒ Replace
❒ Weather-strip
❒ Add kickplate
Other ________________________________________________________
❒ Correct excessive moisture problems
❒ Remove clutter
❒ Organize storage rooms/closets
❒ Store rodent nesting material (fabric, paper, rug scraps, plastic, insulation) in rodent-proof
containers
❒ Clean drains
❒ Screen drains
❒ Cap drains in basement floors
❒ Store human and pet food in pest-proof containers
❒ Improve sanitation
❒ Dispose of insect- or rodent-infested goods
❒ Remove fecal matter (rodents, bats, birds)
❒ Sanitize animal droppings
❒ Investigate secondary pest potential from rodent infestation (e.g. fleas, mites)
L-10
Floor Plan
Building location ______________________________________________________________
Draw a floor plan and mark locations for repairs or pest-proofing.
L-11
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