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HomeMy WebLinkAbout06090239 (2) TERMITE CONTROL MATERIAL USAGE RECEIPT LOT , _ ~r:.E.:. __~"E-O ,~ lJ ')1\\\1 ~'ð'A \y , . . . 'lJot\tS f\.. JUN . ~O OTHER ~ St. ~l.Ibl¡~ ~ I.Icie ~ o"lra 01.11) lJ'. ~L. l~/t'¥'" ) GAL/LBS/OZS (circle one) .. TRUL' nOLEn PEST CONTROL DATE Ib If'·... '" ¡// ,-'11/'" '.. .,~'." '/ . .'. , ,',,/'" V ~o(..,. CUSTOMER NAME ,. ../ I"': t.· ,";" ".4,.../ PROPERTY ADDRESS I ..1:' f. ~' 'C CITY - STATE - ZIP /',. t f '.~ ¡ ([ ¡., ~ / i'.io.... ~ CONTACT IF OTHER THAN ABOVE: NAME ~. ..'_ " //7' ,/ / TELEPHONE TYPE OF CONTRACT - ~~~-:r~~ÈAN MATERIAL USED l'(~/> ··'e 7~- /' \.,/ DRYWOOD , OF CONCENTRATE <I~ QTY USED .~:;( <.,.~'} METHOD OF APPLICATION )/Î (" t· - ¡:-f / Y" ../ .: i ¡ .'( ¡ , '"¡ i~·· f¿. .¿'¡' ¡,. ,,,.. i. f TYPE OF .SERVICE: \/.' NEW CUSTOMER TREATMENT RETREA TMENT TREATMENT PERFORMED ,/ /' COMPLETE TREATMENT SELECTIVE TREATMENT COMMENTS: d'\i," ."' . _ /~~ ..___i.· _ ¿l .- .~2/ '_- / '::::"''Í'ECHNICIAN SIGNATURE CERT . NUMBER '. \~"~ ~ i _, '1 ~~" CUSTOMER SIGNATURE'-' ~.. '/' ..: ~;{ ,I-'~ ( ,;'.:/V/ //'/- (~) 7? \ ..:y:/".: .. ...r' BRANCH ADDRESS / TELEPHONE WARNING - Pesticides can be harmful. Keep children and pets away ~ro. pesticide applications until dry, dissipated or aerated · Truly Nolen Pest control #C4020A ORIGINAL TO BRANCH FILE COpy TO CUSTOMER 7309 (12/01)