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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 PREVENTIONI I i FIRE ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION&REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE d G-5 I?-t TIME I �'L7 60—y'y1
1
DEVELOPMENT NAME(PROJECT) CONTRACTOR'S NAME CONTACT PERSON ��l- -rn� `D v 1
�I-=1e��r�etc:
STRUCTURE ADDRESS(LOT/BLOCK) CITY,STATE COUNTY
5120 Scati100 _'l �tve T=or' , Qi�� �E', 6- L Sr Woe-
NOTES fftrt11 ZIP CODE
TREATMENT TYPE/AREA I
❑FLOATING ❑MONOLITHIC ❑PATIO ❑GARAGE ❑DRIVEWAY ❑STEM WALLIFOOTERS ❑ADDITION
❑CUTOUTS ❑FOOTER l❑FRONT ENTRY ❑RETREAT ❑BORA CARE TREATMENT ❑PLUMBING CUT OUTS ❑SIDEWALKS
❑TAMP&TREAT ' TREAT ONLY D FINAL ❑POOL DECK ❑OTHER
PRODUCTS
\I
❑BASELINE t],DOMINION 2LACTIVE INGREDIENT ❑TERMIDOR SC ❑BORACARE ❑PREMISE ❑TALSTAR
1
❑OTHER
ACTIVE INGREDIENT ❑IMIDACLAPRID ❑BIFENTHRIN ❑DISODIUM OCTABORATE TETRAHYDRATE
CONCENTRATION
❑.06% ❑.1% ❑.12% ❑.25% O 05% ❑23% ❑9% ❑OTHER GALLONS APPLIED T)V
SQUARE FOOTAGE LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
O11YES ❑NO MEASURED OR VERIFIED PER PLANS RECEIVED
JOB READY CONDITIONS MET MAR 18 2021 '
.1
O YES ❑NO DETAILS
St.
"Certificate of Complifince" Lucid 'ount•,
As per 104.2.6,105.10&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 I)V I� 2
I I r
FINAL STICKER
❑,ELECTRICAL PANEL ❑WATER HEATER ❑OTHER
Payment Terms: Payment due at time of service.
' `tttaauwunua�„
Date f Applicator:(Evict A BugrT Fmite and Pest Control,Inc.) tom`
Date Customer(Property Owner or Agent)
www.evictabugpestcontrol.com