U-Haul International 2727 N. Central Ave Phoenix, AZ 85004 1-877-GO-U-Haul

The US Department of Agriculture now requires that all loads going into California must include an inspection checklist indicating that the load is free of Gypsy Moths. Failure to provide this checklist to your local U-Box office prior to shipping may cause delays in your shipment as well as possible additional expense. Please fill out the following checklist in the Gypsy Moth Brochure and provide a copy to your U-Box shipping location. You must retain the original copy. To complete the checklist simply mark any item listed that is inside your U-Box and has been inspected. Also, please include your origin residence address as the 'Place Inspected' as well as the U-Box number for each U-Box that is being shipped to California. Do not forget to sign the bottom of the checklist. Thank you

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communica-tion of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720–2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250–9410, or call (800) 795–3272 (voice) or (202) 720–6382 (TDD). USDA is an equal opportunity provider and employer.

This publication supersedes “Don’t Move Gypsy Moth” (Program Aid No. 1329), published in December 1994 and slightly revised in October 2007.

Issued October 2010

United States Department of AgricultureAnimal and Plant Health Inspection Service

United States Department of AgricultureAnimal and Plant Health Inspection Service

For more information on how you can move gypsy moth-free, go to:

www.yourmovegypsymothfree.com

Self-Inspection

If you decide to do the gypsy moth inspection yourself, include anything accessible to the

insect. Inspect any article left outdoors, stored in areas open to the outside, or stored

indoors but used outside. Use the checklist provided to facilitate the inspection.

Follow these simple steps for gypsy moth inspection:

1. Carefully examine each article.

2. Remove and destroy any life stages found.

3. Check the item off the list.

4. Enter the date and place inspected.

5. Sign at the bottom.

This completed and signed checklist will be

your official certificate of self-inspection.

This certificate should be included with the

paperwork accompanying your move and

given to the driver of the moving van.

If you are moving between April 1 and

August 31, when female moths lay eggs

and the caterpillars spread, you should

inspect your articles on moving day if at all

possible. However, if you complete your

inspection before moving day, you should

protect the articles from any further possibility of infestation by:

Sealing them with tarpaulin or plastic bags,

Packing them immediately into a moving van or truck and keeping the doors

closed or covered, or

Storing them indoors.

Disposable plastic bags will safeguard your articles for several days before a move.

On moving day, simply remove the bags and leave them behind.

INSPECTION OPTIONS

If you inspect for gypsy moths on your own, make sure to thoroughly check all outdoor household articles for egg masses and remove and destroy them.

Ann Czapiewski, USDA

Destroying Life Stages of Gypsy Moth

Professional Inspection

INSPECTION OPTIONS

Ann Czapiewski, USDA Ann Czapiewski, USDA

CHECKLISTIMPORTANT: Make sure this checklist goes with your household goods when you move!

Checklist and Record of Your Self-InspectionDate: __________________ Property address: _________________________________________________________

Recreational or Camping ItemsR� Backpacks R�Ice chests R�TarpsR�Basketball backboards R�Motorcycles R�TentsR�Bicycles R�Motor homes R�Waders or bootsR�Boats R�Recreational vehicles R�Other:________________R�Boat trailers R�SnowmobilesR�Campers R�Sports equipment Household Items R�Air conditioners R�Ladders R�Tanks for propane and oilR�Barrels R�Outdoor doormats R�Television antennasR�Cardboard and wooden boxes R�Outdoor thermometers R�Trash cansR�Clothesline poles R�Refrigerators R�Washing machinesR�Clothespin bags R�Sheets of plastic R�Water hosesR�Empty plant containers R�Shutters R�Weather vanes R�Firewood R�Storage sheds R�Window awningsR�House plants (taken outside during the summer) R�Storm/screen doors and windows R�Other:________________ Building Materials R�Bricks R�Roofing materials R�Welding equipmentR�Cinder blocks R�Sewer pipes R�WorkbenchesR�Cement mixing tubs R�Tools and toolboxes R�Other:________________R�Lumber R�Water pipes Yard and Garden Items R�Animal houses (doghouses, rabbit hutches, etc.) R�Fertilizer spreaders R�Storage shedsR�Barbecue grills R�Flagpoles R�Swimming poolsR�Birdbaths R�Garden tillers R�Tractors and trailersR�Bird feeders R�Garden tools R�Trees, shrubs, and plantsR�Bird houses R�Lawnmowers R�TrellisesR�Bug lights R�Mailboxes R�WheelbarrowsR�Carts R�Picnic tables R�Yard decorationsR�Coldframes R�Porch or patio furniture R�Other:________________R�Driftwood R�Signs and postsR�Fencing R�Snowblowers Children’s Playthings R�Bicycles, tricycles R�Sleds, toboggans R�WagonsR�Playhouses R�Swingsets R�Other outside toys (like trucks

R�Sandboxes R�Tire swings or sand molds

R�Other:________________ Other Items R�Cars or trucks R�Car ramps R�Stored tires (snow tires)R�Car parts R�Farm implements R�Other:________________

Please inspect anything that was stored outside!

Signature: _________________________________________________________________________________(If the inspection was done by a commercial inspection company, provide the name of the firm and its phone number.)

Checklist and Record of Your Self-Inspection Date: ________________

Where You Are Moving From (Street Address, City, State, Zip): _____________________________________________

Checklist and Record of Your Self-Inspection Date: ________________

Where You Are Moving From (Street Address, City, State, Zip): _____________________________________________

I certify that no living creature or organism involving plants are being transported as agreed upon in the U-Box rental agreement

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communica-tion of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720–2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250–9410, or call (800) 795–3272 (voice) or (202) 720–6382 (TDD). USDA is an equal opportunity provider and employer.

This publication supersedes “Don’t Move Gypsy Moth” (Program Aid No. 1329), published in December 1994 and slightly revised in October 2007.

Issued October 2010

United States Department of AgricultureAnimal and Plant Health Inspection Service

United States Department of AgricultureAnimal and Plant Health Inspection Service

For more information on how you can move gypsy moth-free, go to:

www.yourmovegypsymothfree.com