HomeMy WebLinkAboutTerminix Termite Treatment--19D
Customer S)v- Z
Addressss- , 0 o v
City 4 State �L Zip i3 9�i
Phonel_W-r,��l Contract#
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Terminix Address 00 /✓f?/ i cii �,
City gofj �t State L- Zip
Telephone
yfarmni1, WOO Application Record
io id R-Plus Insulation Record
Date of Application /// z 6 / ��13
__ Time Inr Time Out a / r
Applicator(s)/Certif. #mil Irs/p /f/ e 44 .
Supervisor/Certif. #
❑ Original Treatment
Cl Complete Treatment
❑ Retreatment ❑ Pretreatment
/ULimitedTreatment ❑ Perimeter Plus
❑ Attic Insulation ❑
*Wind Speed
Target Pest }KlubterraneanTermites ❑ DrywoodTermites ❑ Old House Borers
Product Applied
Chemical
Manufacturer
EPA# %
'
❑�AlpineTermite Foam
Dinotefuran
BASF
499-526
O BoraThor Max PT
Disodium OctaborateTetrahydrate
Ensystex II, Inc.
81824-11
❑ BoraThor SP
Disodium OctaborateTetrahydrate
Ensystex 11, Inc
81824-8
❑ Bora-Care
Disodium OctaborateTetrahydrate
NISUS
64405-1
❑ Fast Out CS Foam
Cyfluthrin
BASF
499-523
❑ Phantom (SC)
Chlorfenapyr
BASF
241-392
❑ Premise Pre -Construction
Imidacloprid
Bayer
432-1331
�9`Termidor SC (SC)
Fipronil
BASF
7969-210
❑ Termidor 80 (WG)
Fipronil
BASF
7969-209
❑ Tim-Bor (SP)
Disodium OctaborateTetrahydrate
NISUS
64405-8
❑ AdvanceTermite Bait
Diflubenzuron
BASF
499-500
L
*MPH from the (direction)
Ll Powderpost Beetles ❑ Wood Decay Fungi ❑
Applied
❑ 0.025%
❑ 9% ❑ 13% ❑ 16% ❑ 23%
❑ 10% ❑ 15%
❑ 9% ❑ 13% ❑ 16%-❑ 23%
❑ 0.1 %
i
❑ 0.125% ❑ 0.25% / 1
Cl 0.05%
❑ 0.06% ❑ 0.125%
❑ 0.06% ❑ 0,425%
❑ 10% ❑ 15%
❑ 0.25% (124gm)
The following is by Corporate approval only:
❑ Prelude (EC) Permethrin Syngenta 100-997 ❑ 0.5% ❑ 1 % ❑ 2%
❑ TAR Insulation Orthoboric Acid Pest Control Insulation 72787-1-83896 ❑ 11.1 % ❑ 12.5%
Amount
a
Formulation
A=Aerosol
°Z
B=Bait
gal
D=Dust
gal
EC=Emulsifiable Conc.
gal
F=Foam
oz
SC=Suspendible Conc.
gal
SL=Soluble Liquid
SP=Soluble Powder
gal
WG=Water Dispersible
gal
Granules
gal
WP=lvettable Powder
gal
*Application Rate
ea
❑ 4 1/10 linear feet/ft
g
❑ 2 gal/10 linear feet
/41 gal/10 square ft
❑ 1.5 gal/10 square ft
❑ /
gal ❑ Applied at less,
than label rate
❑ Monitoring Stations
30# bags only (no bait)
La *Gas Engine ❑ *Electric motor ❑ *Diaphragm Pump ❑ *Piston Pump ❑ *Roller Pump ❑ *In -Line Injection System
❑ *25 PSI or less at nozzle ❑ *50 PSI or less at nozzle ❑ _*PSI at pump ❑ _*PSI at pump ❑ Insulation Blower
❑ *Hand Duster ❑ *Aerosol Injection ❑ *Compressed Air Sprayer ❑
Areas ireatea: -WSee Below ❑.See Contract Graph ❑ See Atta(
hed Graph
Description of AreasTreated
I
i
' 1 ' % AM CA Control Services have Activity ,/YQ rtA_-
been performed on y property to my satisfaction.
Oustomer it
"VV—
Termite Technician u Notice of Treatment Was Posted At or Near
Date Posted
Manager ❑ Electric Breaker Box _ ❑ Water Heater Closet
Bookkeeper
Q. Bath Trap Access
❑ Beneath the Kitchen Sink
Key #31117 Rev. 8/11 R/P 8/11 02011 TheTerminix International Company Limited Partnership *Complete where applicable.