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• Rodent Service Pest a & 772-348-5000
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• Whitefly Treatment Inc. 4293 SW High Meadows Ave.
• Licensed & Insured Lic. JB175775 Palm City, FL 34990
Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC) 104.2.6, 105.10 & R318.1 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE F TIME D
DEVELOPMENT NAME (PROJECT)) NAME f ONTACT PERSON �ONTRACTOKS
t,��rSo.n �p ri.S-i . Odds
STRUCTURE ADDRESS (LOTIBLO CITY, STAT� � � L I
U �T � C t
540/ -t� l tPIC� � r'1�Pt , . �
NOTEsf ZIP � 7Dc�
-n i mtrrl I TFEIAREA
❑ FLOATING ❑ MONOLITHIC ❑ PATIO ❑ GARAGE ❑ DRIVEWAY ❑ STEM WALUFOOTERS ❑ ADDITION
❑ CUTOUTS ❑ FOOTER ❑ FRONT ENTRY ❑ RETREAT ❑ BORA CARE TREATMENT ❑ PLUMBING CUT OUTS ❑ SIDEWALKS
❑ TAMP & TREAT d.TREAT ONLY FINAL ❑ POOL DECK ❑ OTHER
PRODUCTS
❑ BASELINE 1 DOMINION 2LACTIVE INGREDIENT ❑ TERMIDORSC ❑ BORACARE '❑ PREMISE ❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT
CONCENTRATION
AMIDACLAPRID ❑ BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
❑ .06% ❑ .1% ❑ .12% ❑ .25% A .05% ❑ 23% ❑ 9% ❑ OTHER GALLONSAPPLIED % —2
SQUARE FOOTAGE LINEAR FOOTAGE o 0
SQUARE FOOTAGE VERIFIED
10 YES ❑ NO MEASURED OR VERIFIED PER PLANS
JOB READY CONDRIONS MET
YES ❑ NO DETAILS
"Certificate of Compliance"
As per 104.2.6,105.10 & R318.1 FBC - If soil chemical barrier method for termite prevention is used.
Final exterior treatment shall be completed prior to final building approval.
Certificate of Compliance: The building has received a complete treatment for the prevention of subterranean termites. Treatment is in accordance with rules
and laws established by the Florida Department of Agriculture and Consumer Services. (Per the Florida Building Code.)
If this notice is for the final exterior treatment, Initial and date this line ' ( �� �� O
FINAL STICKER
ELECTRICAL PANEL ❑ WATER HEATER
Pa mew Payment due at time of service.
-vA
Date
Date
❑ OTHER '1
--A
Applicator: (EvictA AI
ug Termite and est Control, Inc.)
.
Customer (Property Nrier orAgent)
www,evictabugpestcontrol.com
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