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1C.OUNTY
230O Virginia Ave
Fort Pierce,FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #:J 05 —01,97JOB ADDRESS: b 0 -,;)k arr 6-o'n S S I
BUILDERJCONTRACTOR:
PEST CONTROL CONTRACTOR: L.-St 11 >° c
PEST CONTROL LICENSE #: :S�S 1 Z�Z\Zd
We, the undersigned, hereby certify that we have pretreated the above described construction for
subterranean termites-in accordance with the standards of the National Pest Control Association.
Square feet if area treated,-1 Chemicals used: C,c OSS 6y t E
Percentage of solution: Total gallons used: _12,
Date of Treatment: l Time of Treatment:. �}
Footing Slab
1 Treatment 1�Treatment
Re-Treat Re-Treat
Driveway Pools
1"Treatment 1 Treatment
Re-Treat Re-Treat
Other !>.�*A Perimeter for Final Inspection
1st Treatment
Re-Treat
Signature of Exterminator
Note: There must be a completed form for each required treatment orre-treaiment and this form mustbe on the jab
site to be puked up by the inspector at time of each inspection or the scheduled inspection will fail and a re-inspection
fee charged.
FBC104.2.6 Certificate of Protecffve Treatment for pievendon of termites A Weather resistant jobsite posting board
shall be provided to receive duplicate Treatment Certificates a9 each required protective freatment is completed,
providing a copy for the person the permit is issued to and another copy for the building pem&fr/es The Treatment
Certificate shall provide the product used,identity of the applicator, time and date of the treatment,site location,area
treated, chemical used,percent concentration and number ofgallons used to establish a verifiable record of
protective treatment. If the soil chemical barrier method for termite prevention is used, final exterior treatmentshall
be completed prior to final building approval.
St Lucie County requires for the final inspection for CO,a Permanent Sticker to be placed on
the electrical panel box cover, listing all the treatments and dates of applications.
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