MCD___________________ Test #___________ Test Date_____________
Chemical_______________________ Concentration___________________
Mosquito Species____________Source___________ Date______________
Mosquitoes Collected As: larvae/pupae/adults Collection Method__________
Bottle Prep Date______ Temperature__________ Test performed by_______
| Time | Treated 1 | Treated 2 | Treated 3 | Treated 4 | Control 1 | Control 2 | Total Treated | Total Control | % Mortality |
| (min.) | D / A | D / A | D / A | D / A | D / A | D / A | D / A | D / A | % |
| 0 | / |
/ |
/ |
/ |
/ |
/ |
/ |
/ |
% |
| 15 | / |
/ |
/ |
/ |
/ |
/ |
/ |
/ |
% |
| 30 | / |
/ |
/ |
/ |
/ |
/ |
/ |
/ |
% |
| 45 | / |
/ |
/ |
/ |
/ |
/ |
/ |
/ |
% |
| 60 | / |
/ |
/ |
/ |
/ |
/ |
/ |
/ |
% |
| 75 | / |
/ |
/ |
/ |
/ |
/ |
/ |
/ |
% |
| 90 | / |
/ |
/ |
/ |
/ |
/ |
/ |
/ |
% |
| 105 | / |
/ |
/ |
/ |
/ |
/ |
/ |
/ |
% |
| 120 | / |
/ |
/ |
/ |
/ |
/ |
/ |
/ |
% |
D= Dead A=Alive