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01/31/2012 17:36 7724626443 SLC INSPECTIONS
III i i -
Cl
COUNTY
2300 VTr'ginia•Ave
Fort Pierce, FL 34982
772-462=2172 Fax 772-462-644-3
CERTIFICATE OFT RMITSTREAT
MENT
CONSTRUCTION-SOIL TREATMENT
P M #: ADDRESS: ',S'J'p�". °.
ER �' �
BUILDER/CONTRACTOk: ;
PEST CONTROL CONTRACTOR:
PEST CONTROL LICENSE',-#*
We, the undersigned, hereby Certify that_we have pretreated•the above:deseribed construction;for
subterranean termites in accordance with the standards.of the National Pest Cary 6"Al'`ssodation.
Square feet iFarea-treated: .5. .- - Chemicals usedAi- " -
01 '
Percentage of solution: C` ° Total gallons used
Date of reatMent: C ? 3 l Time of"Treatment:- O M
Footi7vt
Treatment, 1-Treatment
Re-Treat" Re.Treat
Driveway Fools'
Treatment 1 Treatment
Re-Treat Re,-T at
ther �+,� 'Perimeter f Final Inspection
1
Treatment.,-'-
Re-Treat
reafiment.Re-Treat
Signa a rminatar
IVote: .Mare must be a completed form for each required treatment re- tment and this fonn must be on'the job
site to be pid red up by the hspectorat lame of each inspection"ort scheduled in /orr'wfll fail and.a r�-'irispectron
fee charger!.
" FSCLO4.2.6 &e ca of;#rotectA a Treatment for pr eventlon of termites A w�ea0he r reesistant fpbsllLe posghg board ;
shall be provided to rec�e/Ve dup/kate Tieatment'Certrficatm as each required prott'Wme treatmentis cvrnpteted;
providing a copy her the person the permit fs issued to anis another copy for ttre;bui, 70 r permit'files The Treahnent :
Certificate shall pmv/de the product used,.Tdent/ty of the appllcator, time and date of M e.treatmen0 s/te locatr'an,area ;
treated,chemical crsed,perment cone erfttiorh and number of gallons used,-6 establish a,.veritift record of
protecUm treatment. If the soil chemical barrier method for,termite prevention is used,;final exterior treatment sha!l
be cornplew prior to lnal building approval...
5t Ude County requires for the final inspe Uon for CO,a Permanent Sticker to be placed on.•
the electrical anet box cover tistin alt the treatment*and dates of a lica�ons.-
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