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HomeMy WebLinkAboutProject Information 03 Pre-Construction Termite Treatment sorviccrc K 4 t- d35 7670 Okeechobee Blvd., West Palm Beach, F1. 33411 Phone: 1-800-285-7378 Fax: 561-684-0122 Property Information Builder/Contractor Treatment Date Z 7 Time �O—� Lot Block Name of Builder Subdivision Name Shell Contractor X12 5 W Li gne) L, Street Address(If known) �? Construction Type rcr4 s6 lug:ea FL S 7 City state ;<` .Zip ❑Monolithic ❑Floatin /Stemwall ❑Patio � g Owner's Name (If known) ❑Entry []Driveway AOther: Product/Treatment Information Treatment Type: ❑Underslab ❑Patio/Driveway/Entry ❑Final ('�❑Wood Treatment ❑Bait System Other 69eG Product:4.^ ,®Disodium Octaborate ❑Cypermethrin 71 Imidacloprid- ❑Bifenthrin 71 Permethrin 0 Other: r•;aloe Concentration - A0 Mixed Product Applied Square Feet Treated Linear Feet Treated 6(O ❑ If this box is checked, then Final Perimeter treatment has been completed and the following statement is applicable: Certificate of Compliance: This building has received a complete treatment for the prevention of subterranean termites. This treatment is in accordance with the laws and rules established by the Florida epartment of Agriculture and Consumer Services. A licator's Name fflease print) cator's Signature HES-TE019 02/14 Hulett Environmental Services©2015