HomeMy WebLinkAboutTermite CertEvtl�&� Pta Hml�e�l N-1116.
"Considering Your Environment"
DACS State License # 114708
138 Valencia Street Royal Palm Beach, FL 33411
561-333-87771 Cell 561-202-56251 Cell 561-723-11061 evergladespest@gmail.com
Prope4y Information
Subdivision: _ 1 �. L �r Lot:
Address
City & Zip
Owner
Name of Builder:
Shell Contractor:
go PA16
Block: Section:
w Q ) A --
Builder t Contractor Information
Construction Type
Monolithic: Floating/Stem a Entry:
Driveway:
Addition: Othe
a ment Information
Treatment Date: , Time: _', Ca Technician:
Treatment Type (m st ch ck one} Initial Under Slab: Supplemental:
Product Applied: Cypermethrin: Premise 75
Other
Concentration: ; % Mixed Product Applied: Gallons
Square Footage Treated: 5- 0✓ Linear Feet Treated:
if this is checked, then final perimeter treatment has been completed and the
following statement is applicable:
Certificate of Com Hce:anTHIS BUILDING HAS RECEIVED A COMPLETE TREATMENT FOR THE
PREVENTION OF SUBTERRANEAN TERMITES. TREATMENT IS IN ACCORDANCE WITH THE RULES AND
LAWS ESTABLISHED By THE FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES.
(Florida Building Code (FBC) 1816.1.7)
Applicators Name (Please Print) �/ ��
Pva14,te'.
"Considering Your Environment'
DACS State License # 114708
138 Valencia Street Royal Palm Beach, FL 33411 mail com
561-333-87771 Cell 561-202-56251 Cell 561-723-11061 evergladespest@g
T14�
property Information
Subdivision;�� 7� Lot: Block:
Address
City & Zip
Owner
Name of Builder:
Shell Contractor:
Monolithic: —Z?�-- Floating
Driveway'.
Addition: Other:
0 M
Builder I Contractor Information
Construction T e
�Ot")S C,
Section:
142
Entry;
Time: ' Tec nician:
Treatment Date:-��----
Treatment Type ),(,uqsteck one) Initial Under Slab: Supplemental:
premise 75 '
Product Applied: Cypermethrin:
Other `7- Gallons
Concentration: w redact Applied:
Square Footage Treated: Linear Feet Treated:
_ If this is checked, then final perimeter treatment has been completed and the
following g statement is applicable: NG Certificate of Com llanCe: THI TERMITES. PREVENTION OF SUBTERRAN S H TREATMENT DlS IN ACCORDANCE WITH THE RULES AND
LAWS ESTABLISHED BY THE FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES.
{Florida Building Code {FBC) 1816.11) t
Applicators Name (Please Print)--7t'�4 -