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·'·CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
O.,O"S -038' ~"
PERMIT # o...,tJ"l-~O~B ADDRESS L)$O \ ~~\ ~ rrL
~
BmLDER
'I ~ /
PEST CONTROL CONTRACTOR t '\ \ \ S e.l'f\ EN\) \?o;J ,Nle~\fV\ ~efL-V I eLf
~~- '1L\l\QS
PEST CONTROL LICENSE #
We, the undersigned, hereby certify that we have pretreated the above..(lescribed. construction for
subterranean termites in accordance with the standa.rds of the National Pest Control Association..
Chemicals used:
Square feet of area treated: .::S s~.s--
"S33
.. Z,
s::-/c¡--::¡
Total gallons used:
Percentage of solution:
CJFooting
r:J 1st Treatment
\/\ D. Ref"'treat
rwSlalz1
. D-l st Treatment
ORe-treat
o Driveway
o 1st Treatment
ORe-treat
a Pools
o 1st Treatment
ORe-treat
LJ Other
o 1st Treatment //
CJ Re-trðât ('
"---
Q Perimeter for Final Inspection
Date of treatment:
Time of Treatment:
FBCI04.2.6 Certificau òf Prf)tltt.:til1l! TretJttnett1./0r prellention ofttrnUtss.
A weather resistan.t jobsitt! posting board shall be provided to rt.ceive
duplicate Treátment Certificate! as each required protective treatmlmt is
compkted, providing a copy for the person the permit is ÏJsued to and
another copy for the building permit [des. The Treatment Certificate jhall
provide the product used, identity o/lhe applicaror. time and date ofrht.
treatment. site locatiDn, area treated, ch~trtica.l used. pèrct:nt con.centration
and 1I.1I.mberolgalloTlS used, to establish a verifiable record afprotective
treatment. if the soil chemical barrier method for termite prevention. i1 uscd,
final exterior treatme111 shall be completed "rior to final building approval.
St Lude County requires fór the fioäl inspection for CO, B Permanent
Sticker to be placed on the electrical panel box coveS", listing r.Il the
treatments and dates of applications.
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.----- ---------
,/
Signature of exterminator
NOTE:
There must be a completed fomJ for each requit'ed treatment or re-treatment and this f'Onn must be on
the job site to be picked up by the inspector at time of each inspectiort. or the scheduled inspection wiU
fail and a re-in.çpectÎon fee charged.
Rt,'is~J 6/13102 dmg