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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 TIME
DEVELOPMENT NAME (PROJECT)CONTRACTOR'S NAME CONTACT PERSON
�I
STRUCTURE ADDRESS (LOT/BLOCK) f CITY, STATE COUNTY
NOT1S FLIC,afS IaT'RA✓h7'1-A/44 ZIP CODE
� � I ��,'f _ r. — _ r. :, r �4
TREATMENT TYPEIAREA
❑ FLOATING ❑ MONOLITHIC ❑ PATIO ❑ GARAGE ❑ DRIVEWAY
❑ CUTOUTS ❑ FOOTER ❑ FRONT ENTRY ❑ RETREAT ❑ BORA CARE TREATMENT
❑ TAMP & TREAT _.-4/TR.EAT ONLY ;` _G�.�INAL ❑ POOL DECK ❑ OTHER
❑ STEM WALLIFOOTERS ❑ ADDITION
❑ PLUMBING CUTOUTS ❑ SIDEWALKS
PRODUCTS
❑ BASELINE (] DOMINION 2LACTIVE INGREDIENT ❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE ❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT
CONCENTRATION
❑.06% ❑.1%
SQUARE FOOTAGE
❑" IMIDAQLAPRID ❑ BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
❑ .12% ❑ .25% ❑,A% ❑ 23% ❑ 9% ❑ OTHER
SQUARE-FOOTAGE-VERIFIEB —
BYES ❑ NO I
f l MEASURED OR`VERIFIED PER PLANS
(,
JOB READY CONDITIONS MET
t<7 YES ❑ NO DETAILS
GALLONS APPLIED
LINEAR FOOTAGE
"Certificate of Compliance"
As per l04.2.6,105.10 & 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
FINAL STICKER
q ELECTRICAL PANEL ❑ WATER HEATER
F
Nyment Terms: Payment due at time of service.
Date
❑ OTHER
Applicator: (EwctA Bug Termite and Pest Control, Inc.)
Date Customer (Property Owner or Agent)
www.evictabugpestcontrol.com