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2300 Virginia Ave-
Fort Pierce, FL 34982
772-462-21.72 Fax 772-4.62-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TR9ATMENT
PERMIT #: JOB ADDRESS: &C
BUILDER/CONTRACTOR:
PEST CONTROL CONTRACTOR: ' A-yi 3CIL
PEST CONTROLLICENSE #: 141c.Y
We, the undersigned, hereby certify that we have pretreated'the above described construction for
subterranean termites in accordance with the standards of the National Pest Control Association.
Square feet if area treated: 41,9 (ver Chemicals used:&)L i c_
Percentage of solution: a5°XI Total gallons used: 9
Date of Treatment: (o-15�- 18 Time of Treatment:- /ail=y0-
Footing Slab
1st Treatment V Treatment
Re-Treat Re-Treat
Driveway Pools
1't Treatment 1st Treatment
Re-Treat , Re-Treat
_Other 44er;or ,,, -z" iFjo mfavx-d-XAWce Perimeter for Final Inspection
1st Treatment
Re-Treat
Signature o erminator
Note:"There mw�be a completed form for each required treatment or re-treatment and this form must be on the job
site to be picked up by the inspector at time of each inspection or the scheduled inspection will fail and a re inspection
fee charged.
FBC104.2.6 Certificate of"Protective Treatment for pf`evention of termites A weather resistant jobsite posting board
shall be provided to receive duplicate Treatment Certificates as each required protective treatment is completed,
providing a copy for the person the permit is issued to and another copy for the building permit files The Treatment
Certificate shall provide the product used, identity of the applicator, time and date of the treatment, site location, area
treated, chemical used,percent concentration and number of gallons used,-to establish a verifiable record of
Protective treatment. If the soil chemical barrier method for termite prevention is used, final exterior treatment shall
be completed prior to final building approval.
StLucie County requires for the final inspection for CO, a Permanent Sticker to be placed on
the electrical panel'box cover, listing all the treatments and dates of applications.
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