Rodent Drain Inspection Survey Form
Document your rodent drain inspection findings in detail using this survey form.
Property/Location Identification
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
First Name
Last Name
Drain Area Inspected
*
Please Select
Kitchen
Bathroom
Basement
Garage
Garden/External
Other
Signs of Rodent Activity Observed
*
Droppings
Gnaw marks
Tracks/footprints
Odor
No signs
Other
Signs of Drain Damage or Blockage
*
Cracks
Blockage
Standing water
Corrosion
No damage
Other
Condition of Access Points / Covers
*
Secure and intact
Loose or missing
Damaged
Not accessible
Evidence of Nesting or Droppings
*
None found
Nesting material present
Droppings present
Both nesting and droppings
Overall Severity Rating
*
1
2
3
4
5
Recommended Follow-up Actions
*
Submit Inspection
Should be Empty: