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The California Gypsy Moth Checklist form is an essential tool for anyone planning to move from a gypsy moth quarantine area to a non-quarantine area. This form outlines the legal requirements for inspecting outdoor household items to prevent the spread of this invasive pest. Before moving, individuals must check their belongings for any life stages of the gypsy moth, which can cause significant damage to various trees and shrubs. Failure to comply with this inspection requirement can result in penalties. The checklist provides a straightforward process for self-inspection, allowing individuals to examine items such as patio furniture, lawn equipment, and recreational vehicles for gypsy moth egg masses. If preferred, a qualified certified applicator can perform the inspection. The completed checklist serves as an official certificate, which must be kept on hand during the move. It is also advisable to retain a copy for future reference. For those unsure whether they reside in a quarantine area, the form directs users to a helpful website that provides this information. Additionally, resources are available for further assistance, including contact details for state agricultural departments and the USDA. Understanding and utilizing this checklist can help protect new neighborhoods from the gypsy moth's destructive impact.

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IT’S THE LAW: BEFORE MOVING, CHECK FOR THE GYPSY MOTH

What Does the Law Require?

If you are moving from a gypsy moth quarantine area to a non-quarantine area, you must inspect your outdoor house- hold items for the gypsy moth and remove all life stages of this destructive insect before you move. You may face penalties if you are required to inspect but fail to do so. Fortunately, this inspection is easy to do, and you will protect your new neighborhood from a voracious leaf eater that can attack over 300 kinds of trees and shrubs.

How Do I Know if I Live in a Gypsy Moth

Quarantine Area?

Visit www.YourMoveGypsyMothFree.com and click on the U.S. map to find out if you live in a quarantine area. If you do, you will need to inspect your household goods for gypsy moth if you’re moving to a non-quarantine area. If you do not live in a quarantine area, this law does not apply to you.

I Live in a Quarantine Area and Am Moving to a Non-Quarantine Area. How Do I Meet This Legal Requirement?

1)Use the self-inspection checklist on the back of this flyer r hire a qualified certified applicator to inspect your outdoor

household articles. If you are moving between April and August, you should complete the inspection on moving

day, if possible. If you cannot complete the inspection on moving day, you must protect the items from the possibility of infestation by sealing them under a tarp, keeping them indoors, or in a closed moving truck.

For self-inspection, follow these steps:

Carefully inspect all surfaces and crevices of your outdoor household articles such as patio furniture, lawn equipment, toys, grills, trailers, and vehicles for gypsy moth egg masses.

Remove and destroy any egg masses you find. Scrape them off with a putty knife, stiff brush, or similar hand tool. Dispose of egg masses and other life stages in a container of hot, soapy water, or place them in a plastic bag, seal it, and set it in the sun.

Check each item off on your checklist as you go, and complete the requested information.

If a qualified, certified applicator performs the inspection, be sure you get a copy of the completed, signed checklist.

2)During your move, keep a copy of the completed checklist in the vehicle moving the goods in case a U.S. Department of Agriculture (USDA) or State official requests it at any point during your trip. If you are not driving, provide a copy to the driver. This completed checklist is an official certificate that will satisfy the requirements of all

non-infested States.

3)Once your move is completed, you may want to keep the checklist filed with your moving materials in case you need it in the future.

Where Do I Go For Help?

See the back of this flyer for photos of all gypsy moth life stages.

Learn more at www.YourMoveGypsyMothFree.com.

Contact your State Department of Agriculture or nearest USDA Animal and Plant Health Inspection Service (APHIS) office (www.aphis.usda.gov/planthealth/sphd).

USDA is an equal opportunity provider, employer, and lender.

This publication supersedes Program Aid No. 2065, “Your Next Move Gypsy Moth-Free,” which was published in October 2010.

Issued October 2013

Revised September 2018

Animal and Plant Health Inspection Service Program Aid No. 2147

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0104. The time required to complete this information collection is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

OMB APPROVED

0579-0104

EXP. DATE 09/30/2021

UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE PLANT PROTECTION AND QUARANTINE

GYPSY MOTH CHECKLIST AND

RECORD OF YOUR SELF-INSPECTION

Important: Make sure this checklist goes with your outdoor household items when you move

1. Originating Property Address

 

 

2. Date

 

 

 

 

3. Recreational or Camping Items

 

 

 

Backpacks

Ice Chests

Tarps

Basketball Backboards

Motorcycles

Tents

Bicycles

Motor Homes

Waders or Boots

Boats

Recreational Vehicles

Other: _____________________

Boat Trailers

Snowmobiles

None

Campers

Sports Equipment

 

 

 

 

 

 

4. Household Items

 

 

 

Air Conditioners

Ladders

Tanks for Propane and Oil

Barrels

Outdoor Doormats

Television Antennas

Cardboard and Wooden Boxes

Outdoor Thermometers

Trash Cans

Clothesline Poles

Refrigerators

Washing Machines

Clothespin Bags

Sheets of Plastic

Water Hoses

Empty Plant Containers

Shutters

Weather Vanes

Firewood*

Storage Sheds

Window Awnings

House Plants (taken outside

Storm/screen Doors and Windows

Other: _____________________

during the summer)

 

None

 

 

5. Building Materials

 

 

 

Bricks

Roofing Materials

Welding Equipment

Cement Mixing Tubs

Sewer Pipes

Workbenches

Cinder Blocks

Tools and Toolboxes

Other: _____________________

Lumber

Water Pipes

None

 

 

 

 

6. Yard and Garden Items

 

 

 

Animal Houses (doghouses,

Fertilizer Spreaders

Storage Sheds

rabbit hutches, etc.)

 

 

 

Barbecue Grills

Flagpoles

Swimming Pools

Birdbaths

Garden Tillers

Tractors and Trailers

Bird Feeders

Garden Tools

Trees, Shrubs, and Plants

Bird Houses

Lawnmowers

Trellises

Bug lights

Mailboxes

Wheelbarrows

Carts

Picnic Tables

Yard Decorations

Cold Frames

Porch or Patio Furniture

Other: _____________________

Driftwood

Signs and Posts

None

Fencing

Snow-blowers

 

 

 

 

 

 

7. Children’s Playthings

 

Other Outside Toys (like trucks or

Bicycles, tricycles

Swing sets

sand molds)

Playhouses

Tire Swings

Other: _____________________

Sandboxes

Wagons

None

Sleds, Toboggans

 

 

 

 

 

 

 

8. Other Items

 

 

 

Cars or Trucks

Farm Implements

None

Car Parts

Stored Tires (snow tires)

 

 

Car Ramps

Other: _____________________

 

 

 

 

 

 

Gypsy moth egg masses on a lawn mower (USDA/APHIS, Susan Lane)

Gypsy moth egg mass on a padlock (USDA/APHIS, Susan Lane)

Gypsy moth caterpillar (larva)

(Daniel Herms, The Ohio State University, Bugwood.org)

Gypsy moth pupae

(Pennsylvania Department of Conservation

and Natural Resources, Forestry Archive,

Bugwood.org)

Female (top) and male adult gypsy moths (USDA APHIS PPQ Archive, USDA/APHIS/PPQ, Bugwood.org)

Inspect anything that was stored outside

By signing my name in block 9 below, I agree that I am legally signing this document and affirming that I have inspected all outdoor household articles, whether included on this checklist or not, for all life stages of gypsy moth in accordance with the procedures on this form, as required by Title 7, Code of Federal Regulations, Part 301.45-4(a).

9.Signature and Date

11.Printed Name

10. Phone Number

12.Company Name (if applicable)

* To avoid spreading other tree pests, move only USDA- or State-certified, treated, and labeled firewood.

PPQ Form 377

SEP 2018

Note: The electronic signature function on this form works only if the user opens the file in Internet Explorer or Adobe Acrobat.

Form Specifications

Fact Name Details
Legal Requirement Individuals moving from a gypsy moth quarantine area to a non-quarantine area must inspect their outdoor household items for gypsy moth life stages.
Inspection Process Inspectors can either self-inspect using a checklist or hire a certified applicator. The inspection should ideally be done on moving day.
Quarantine Area Identification To determine if you live in a quarantine area, visit www.YourMoveGypsyMothFree.com and check the U.S. map provided.
Checklist Importance The completed checklist serves as an official certificate. It must be kept accessible during the move in case of inspection by USDA or state officials.
Inspection Steps Carefully inspect all surfaces of outdoor items for egg masses. Remove and destroy any found egg masses using appropriate tools.
Record Keeping After the move, it is advisable to keep the checklist filed with moving materials for future reference.
Governing Law This checklist is governed by Title 7, Code of Federal Regulations, Part 301.45-4(a).

California Gypsy Moth Checklist: Usage Guidelines

Filling out the California Gypsy Moth Checklist is an important step if you are moving from a gypsy moth quarantine area to a non-quarantine area. This form helps ensure that you have inspected your outdoor household items for any signs of the gypsy moth before your move. Completing the checklist accurately will not only help you comply with the law but also protect your new community from this invasive pest.

  1. Begin by entering your Originating Property Address at the top of the form.
  2. Next, fill in the Date of your inspection.
  3. In the section for Recreational or Camping Items, check all applicable items such as backpacks, bicycles, and tents. If you have items not listed, write them in the space provided.
  4. Move on to the Household Items section. Again, check all items that apply, like air conditioners and outdoor doormats. Add any other items in the provided space.
  5. In the Building Materials section, mark any relevant items such as bricks or tools. Note any additional items in the space provided.
  6. Proceed to the Yard and Garden Items section. Check off items like lawnmowers and garden tools, and list any other items as needed.
  7. For Children’s Playthings, check all applicable toys and play equipment. Write in any additional toys if necessary.
  8. In the Other Items section, mark any relevant items such as cars or stored tires. Include any other items in the space provided.
  9. Once you have inspected everything, sign your name in block 9 to affirm that you have completed the inspection.
  10. Fill in the Printed Name, Phone Number, and Company Name (if applicable) in the designated fields.

After completing the checklist, keep a copy in your vehicle during the move. This document may be requested by officials from the U.S. Department of Agriculture or State authorities. Once your move is finished, it’s a good idea to file the checklist with your moving materials for future reference.

Your Questions, Answered

What is the California Gypsy Moth Checklist form?

The California Gypsy Moth Checklist form is a document that individuals must complete when moving from a gypsy moth quarantine area to a non-quarantine area. This checklist helps ensure that all outdoor household items are inspected for gypsy moth life stages, which can harm trees and shrubs. Completing this checklist is not only a legal requirement but also a way to protect your new neighborhood from potential infestations.

Why is it important to inspect for gypsy moths?

Gypsy moths are known to be destructive pests that can damage over 300 types of trees and shrubs. Inspecting for these pests is crucial because they can easily spread to new areas if not properly managed. By conducting a thorough inspection and removing any egg masses or larvae, you help safeguard the environment and maintain the health of local flora.

How can I find out if I live in a gypsy moth quarantine area?

To determine if you reside in a gypsy moth quarantine area, visit www.YourMoveGypsyMothFree.com. There, you can click on a U.S. map that will guide you to the relevant information. If you find that you live in a quarantine area, you will need to follow the inspection requirements when moving to a non-quarantine area.

What steps should I take if I live in a quarantine area and am moving?

If you live in a quarantine area and are moving to a non-quarantine area, you have two options. You can either conduct a self-inspection using the checklist provided or hire a qualified certified applicator to perform the inspection. If you choose to do it yourself, inspect all surfaces and crevices of your outdoor items for gypsy moth egg masses, remove any you find, and complete the checklist. Ensure that you keep the checklist with you during your move as proof of compliance.

What should I do if I find gypsy moth egg masses?

If you discover gypsy moth egg masses during your inspection, it is important to remove and destroy them. You can scrape them off with a putty knife or stiff brush and dispose of them in a container of hot, soapy water. Alternatively, you can place them in a sealed plastic bag and leave it in the sun. Proper disposal helps prevent the spread of these pests.

Do I need to keep a copy of the checklist after my move?

Yes, it is advisable to keep a copy of the completed checklist with your moving materials even after your move is finished. This document serves as an official certificate that verifies you have complied with the inspection requirements. It may be useful for future reference or in case you need to provide proof of inspection later on.

What if I cannot complete the inspection on moving day?

If you are unable to complete the inspection on the day of your move, you must protect your items from potential infestation. This can be done by sealing them under a tarp, keeping them indoors, or storing them in a closed moving truck. It is essential to take these precautions to minimize the risk of transporting gypsy moths.

Where can I find more information about gypsy moths?

For additional information about gypsy moths, including their life stages and inspection procedures, you can visit www.YourMoveGypsyMothFree.com. You can also contact your State Department of Agriculture or the nearest USDA Animal and Plant Health Inspection Service (APHIS) office for assistance and guidance.

What happens if I fail to comply with the inspection requirements?

Failing to comply with the inspection requirements can lead to penalties. If you are moving from a quarantine area and do not conduct the necessary inspections, you may face legal repercussions. It is crucial to take this responsibility seriously to avoid potential fines and to protect the environment.

Common mistakes

  1. Failing to check if you live in a gypsy moth quarantine area. Always verify your status before moving.

  2. Not inspecting all outdoor household items. Make sure to check every item that has been outside.

  3. Forgetting to remove and destroy any egg masses found. It’s crucial to dispose of them properly.

  4. Not using the self-inspection checklist correctly. Each item needs to be marked off as you inspect.

  5. Failing to keep a copy of the completed checklist in the moving vehicle. This document is essential if requested by officials.

  6. Not sealing items properly if the inspection cannot be done on moving day. Protect items from infestation.

  7. Ignoring the need for a qualified applicator. If unsure, hiring a professional can save you from mistakes.

  8. Not filing the checklist with moving materials after the move. It may be needed in the future.

  9. Overlooking the importance of inspecting items like vehicles and outdoor furniture. All surfaces must be checked.

  10. Neglecting to provide necessary information on the checklist, such as your name and contact details.

Documents used along the form

When preparing for a move from a gypsy moth quarantine area to a non-quarantine area in California, several forms and documents may be necessary to ensure compliance with the law. Understanding these additional documents can help streamline the process and avoid potential issues. Below is a list of commonly used forms that accompany the California Gypsy Moth Checklist form.

  • Self-Inspection Report: This document serves as a personal record of the inspection you conducted on your outdoor household items. It details the items checked and confirms that you have searched for gypsy moth life stages. Keeping this report can be beneficial for your records and may be required by authorities during your move.
  • Certificate of Inspection: If you choose to hire a certified applicator for the inspection, they will provide you with a Certificate of Inspection. This official document verifies that a professional has examined your items and found them free of gypsy moths. It is essential to keep this certificate on hand during your move.
  • Moving Contract: This document outlines the terms and conditions of your moving services. It typically includes details about the items being transported, timelines, and costs. Having a clear moving contract helps ensure that both you and the moving company are on the same page regarding responsibilities, including the handling of inspected items.
  • State Quarantine Notification: This form may be issued by the State Department of Agriculture to inform you of the specific regulations and requirements related to gypsy moths in your area. It serves as an important reference to understand any additional obligations you may have before relocating.

Being aware of these forms and documents can greatly ease the moving process. Proper preparation not only helps you comply with legal requirements but also protects your new community from potential infestations. Always keep these documents organized and accessible during your move to ensure a smooth transition.

Similar forms

The California Gypsy Moth Checklist form is similar to several other documents that serve similar purposes in ensuring compliance with regulations regarding pest control and inspections. Here are five documents that share similarities:

  • California Invasive Species Regulation Form: Like the Gypsy Moth Checklist, this form requires individuals to inspect their belongings for invasive species before moving. It emphasizes the importance of preventing the spread of harmful pests to new areas.
  • Pest Control Inspection Report: This document is used by pest control professionals to certify that a property has been inspected and treated for pests. Similar to the Gypsy Moth Checklist, it provides a record of compliance with pest management regulations.
  • Quarantine Compliance Certificate: Issued when a property has been inspected and found free of certain pests, this certificate serves a similar purpose as the Gypsy Moth Checklist. It ensures that items being transported are not carrying harmful pests.
  • Moving Company Inspection Form: Many moving companies require an inspection form to confirm that items being moved are free from pests. This form, like the Gypsy Moth Checklist, helps protect the new environment from potential infestations.
  • State Department of Agriculture Inspection Form: This form is used to document inspections conducted by state officials to ensure compliance with agricultural pest regulations. It parallels the Gypsy Moth Checklist in its focus on preventing the spread of pests during relocations.

Dos and Don'ts

When filling out the California Gypsy Moth Checklist form, it is crucial to follow specific guidelines to ensure compliance with the law and protect your new neighborhood from this invasive pest. Below is a list of dos and don'ts to help you navigate this process effectively.

  • Do inspect all outdoor household items thoroughly for gypsy moth egg masses and other life stages.
  • Do complete the inspection checklist on the day of your move, especially if moving between April and August.
  • Do seal items under a tarp or keep them indoors if you cannot inspect them on moving day.
  • Do remove and destroy any egg masses you find using appropriate tools.
  • Do keep a copy of the completed checklist in your vehicle during the move.
  • Don't ignore the requirement to inspect if you are moving from a quarantine area.
  • Don't dispose of egg masses in regular trash; use hot, soapy water or seal them in a plastic bag and place them in the sun.
  • Don't forget to obtain a copy of the signed checklist if a certified applicator conducts the inspection.
  • Don't move untreated firewood; ensure it is USDA- or State-certified and labeled.

By adhering to these guidelines, you can ensure a smoother moving process while helping to prevent the spread of gypsy moths. Always remember that the responsibility of inspection lies with you, and taking these steps is essential for protecting both your belongings and the environment.

Misconceptions

  • Misconception 1: The checklist is optional.
  • In reality, if you are moving from a gypsy moth quarantine area to a non-quarantine area, using the checklist is mandatory. Failing to do so can lead to penalties.

  • Misconception 2: Only certain items need inspection.
  • Every outdoor household item must be inspected. This includes patio furniture, toys, vehicles, and any other items stored outside.

  • Misconception 3: Inspections can be done at any time.
  • It is best to conduct the inspection on the moving day, especially if you are moving between April and August. This timing helps ensure that any potential infestations are caught early.

  • Misconception 4: You can just spray insecticide to solve the problem.
  • Simply using insecticide is not sufficient. You must physically inspect and remove any gypsy moth life stages you find. This includes egg masses and caterpillars.

  • Misconception 5: The checklist does not need to be kept during the move.
  • It is crucial to keep a copy of the completed checklist with you during the move. This document serves as proof of compliance and may be requested by officials.

  • Misconception 6: The checklist is only needed for homeowners.
  • Renters and anyone moving items from a quarantine area must also complete the checklist. The law applies to all individuals moving from affected areas.

  • Misconception 7: You can dispose of egg masses anywhere.
  • Egg masses must be disposed of properly. Options include placing them in hot, soapy water or sealing them in a plastic bag and placing them in the sun.

  • Misconception 8: The gypsy moth inspection process is complicated.
  • The inspection process is straightforward. Following the checklist and guidelines will make it manageable and effective in preventing infestations.

Key takeaways

  • Legal Requirement: Individuals moving from a gypsy moth quarantine area to a non-quarantine area must inspect their outdoor household items for gypsy moths. This inspection is essential to prevent the spread of this destructive pest.
  • Self-Inspection Process: A self-inspection checklist is available for individuals to use. They should carefully check all surfaces and crevices of outdoor items, removing any egg masses found and properly disposing of them.
  • Documentation: It is important to keep a copy of the completed checklist during the move. This serves as an official certificate that may be requested by USDA or State officials at any point during the journey.
  • Future Reference: After the move, it is advisable to keep the checklist filed with moving materials. This can be useful for future reference or in case of any inquiries regarding compliance.