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EE121'IFICATE •Qk I%RMTTE TREATMENT :a -,
sOIVSTIiUCTION
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70i3YAbDRESS 5609 Buch Dr;POaf PierceFL 34982_3825
BUIIDT;R, Adams. Homes Sauth
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PEST Co TROL CON TRACTOR'.RomeVam P.estDefense, Inc!"'
AST CONTR&IICENSE #
J100018'86'
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we, the undersigned) herebg certtf}
thR-wz have pretreated th=des e ahovecritked cons truetkop
suhterranCan tecittites in accordancewith
the standards of the Nationa!PbeSt.Contc of ssociatidw
Sggare: feet of area treatgd';, r22Q.
Chemicais,used: Bora Care. , _ .. •
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Peiceitta "eYof soluhon::501a
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1bt9i1 gallaus used:, 4 r
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Date of ti'eafiuent 05I1512U l
Time ot``freatrrtente AM � ° 1 •
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E130104 2 6 Cez[ificate ofProtec«ve Matnient far prevention o j Termites.
M FOotlilg; y ,
R wegtherreststant jobsne fdslingboard sliall be pr6Di d to receive , i
•• St Treatment - ,'
d9tp11Ca1eTreatment.Gerti�cates'w`;each:requiredprotecttvC,treatmerit'is
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e Q R; e-treat —
cornpleted, provFding a copy for the persM the poerthet is trsaed io-and
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l another copyfor t ¢ butldtngpermit feles, 2i e TreatrMenl C'&r w to shall
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provide-iheprodactwsed tdeniliyt 7f heapphcator ttmpd-date:ofthe
0.15t Tre$LmE rit-
treahnent; slie7ocation, ,a'rea meated' chemical used percent concentranoo
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and numberofgdlions'tired•toeskabltslt:awenfiableregottlofp,;oteenve:-
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- Retreat
treairaenta ,Ifthe-s'vll cheinl olhai-K& tnethodfor,ter'mi6e prevenhgri`ts tired,
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❑.Driveway _
final ezCerior treatment shall be to jin6{ btoditig approval, '
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LI st Tteatment'
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Sk L-u'c a Cowlty�tequires tot the final tuspection foM�CO, a.Permanent
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Shcker`to beplace_ l on the electrical panel box cover, istmg aliihe `
PUOYS
treatments'and dates of applications
1st'Treatment
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(l Re treat;
0 Other ' .
_ Signature of exterminator
- ❑ tst `treatment
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®Penmetelr for Ah"Inspect
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NOTE."There must be a eoo;pte.ted form for each,eegt ired treatment or re treahnent andthts form:must be,om
the job,site to be picked «p'bydte inspeetor,artirne of eachrispechoti;or, the scheduled inspec«ori_ rvi11
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