HomeMy WebLinkAboutPre-Construction Termite TreatmentR
Ialt 7LETT
enviral
services
Pre-Construction
Termite Treatment
QualityPro'
7670 Okeechobee Blvd., West Palm Beach, FI. 33411
Phone: 1-800-285-7378 Fax: 561-684-0122
Property Information
Builder/Contractor
Treatment Date -� Time ` 1M
Lot Block
Name of Builder
Subdivision Name
�2 I"U l/�
0 (
Shell Contractor
_Street Address (If known)
94 G"/ 349s(
Construction Type
vQTMonolithic []Floating/Stemwall OPa-
City State zip
' {�
do �
�,.
DEntry []Driveway ®Other: NP
_Owner's Name (If known)
Product/Treatment Information
Treatment Type: ❑ Underslab
❑ Patio/Driveway/Entry 0 yal
❑ Wood Treatment
❑ Bait System ®/Other
Product: ❑ Disodium Octaborate
❑ Cypermethrin
❑ Imidacloprid
❑ Bifenthrin
❑ Permethrin�
❑ Other: 2 fO(Ig,i; l
Concentration .O(o ci�
Mixed Product Applied ! %
i
J
Square Feet Treated
Linear Feet Treatedjd�
®�f this box is checked, then Final Perimeter treatment has
been completed and the following statement is applicable:
Certificate of Compliance: This building has received a complete treatment for the prevention of
subterranean termites. This treatment is in accordance with the laws and rules established by the
Florida Department of Agriculture and Consumer Servict3
I
Applicator's Name (please print) Apl3lica o-C lgnature
HES-TE019 07/19 Hulett. Environmental ServicesO 2019