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St Lucie County Inspections
2300 Virginia Avenue
Ft Pierce, FL 349~2
(772) 462-2172
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',. CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #
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Q;~Vl3 ~
BmLDER
JOB ADDRESS ~ (}'O
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PEST CONTROL CONTRACTOR t ~\ \ \ S e.rJ\ EN\) \.{2.0¡J ;vte,^J~ ~ef2-V I eLf
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PEST CONTROL LICENSE #
We, the undersigned, hereby certify that we have pretreated the above..described construction fQr
subterranea.n termites in accordance with the standards of the National Pest Control Assodation.
Square feet of area treated: '3 ðèJO Chemicals used: ~ö1ò~ \ßÅ.. 'TC-
Percentage of solution: ' C< S- )ta
Date of treatment: (~. ~ l - 0 I
Total gallons used:
,'3g-o
Time of Treatment:
o Footing
r:J 1st Treatment
tv! 0 Re~treat
~ Slab
, t.r18t Treatment
ORe-treat
o Driveway
o 1st Treatment
r:J Re-treat
a Pools
o 1st Treatment
o Re-tr~at
Q Other
D 1st Treatment
{:J Re-treat
CJ Perimeter for Final Inspection
FBCI04.2.6 Certificate of Prótèétivl! Treatmetl1.for pre1l/mnon Qftermiles.
A weather resistant jDbsitt! posting board shall be provided to rltceivi!
duplicate Treatment Certificatt!3 tU t!åc1t. requíred prott!ètive treatment is
completed. providing a copy for the person the permit is issued to and
another copy for tlte buildin.g permit files. The Treatment Certificate shall
provide the product used, identity of the applicator, time and date of tit#!.
treatment, site location, area treated. ch~mical U$ed. përCe1lt concentration
and number of galloTls used, to establish a verifiable record of protective
treatment. If the .roil chemical barrier method frJr termite prevention is used,
fin(Zl exterior treatment .'ihall be completed prior to final building approval.
St Lude County requires for tbe final inspèètion for CO, a Permanent
Sticker to be placed on the e]ectrical pa.ne1 box cover, listing øll the
treatments and dates of applications.
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Signature of exterminator
NOTE:
Tl1erè mU$t be a completed fonn for each required treatment or re-treatment and thi.s fonn mu.st be on
the job site to be picked up by the inspector at time of each inspection or the scheduled inspection will
fail and a re-inspection fee charged.
Rt"Isf:ø 6/13102 dmg