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HomeMy WebLinkAboutPre-Construction Treatment Treatmentf '67 vk, 1 r Pre -Construction aenv9a anv.ne-nt:aA Termite Treatment 7670 Okeechobee Blvd., West Palm Beach, F1. 33411 Phone: 1-800-285-7378 . Fax: 561-684-0122 Property Information Builder/Contractor Treatment Date W911leTime Lot - Block Name of Builder Subdivision Name Shell Contractor I O �\)y) RQtt)d )�. Construction Type Street Address (If known) 24onolrthic OFloating/Stemwall OPatio City f State zip OEntry ODriveway: OQther: Owner's Name (if known) ProductTOeatment Information, 1Yeatment Type: nderslab. ❑ Patio/Driveway/Entry ❑ Final ❑ Wood Treatment ❑ Bait System ❑ Other Q� Product: ❑ Disodi ctaborate ❑ Cypermethrin midacloprid ❑ Bifenthrin ❑ Permethrin ❑ Other:' ;, Concentration Mixed Product Applied Square Feet Treated Linear Feet Treated ❑ If this box -,is checked, then. Final Perimeter treatment has been completed and the following statement, is applicable: Certificate of Compliance: This building has received 'a complete treatment for the prevention of subterranean termites. This treatment is in accordance with the laws and rules established by the Florida Department of Agriculture and Consumer Services. Applicator's Name (please print) Applic s Signature HES-TE019 10/ 11 uiett Environment ervim@ 2011 -V _ P -Construction HULE'TT Termite Treatment • anvirasie.ncnt.a vabrvicaes 7670 Okeechobee Blvd., West Palm Beach, FI. 33411 Phone: 1-800-285-7378 Fax: 561-684-0122 Property Information Builder/Contractor Treatment Date IT— p Time ILK M911 Name of Builder Lot 91 Block R��X &, Subdivision Name i Shell Contractor 10 ' Construction Type Street Address (If known) t El 3 04onolithic ❑Floating/Stemwall ❑Patio ity State Zip ❑Entry ❑Driveway ❑Other: Owner's Name (If known) Product/Treatment Information Treatment Type: nderslab ❑ Patio/Driveway/Entry ❑ Final ❑ Wood Treatment ❑ Bait System ❑ Other Product: ❑�Disodiictaborate ❑ Cyperinethrin d ❑ Bifenthrin ❑ Permethrin ❑ Other: Concentration �� Mixed Product Applied Square Feet Treated LA' s d Linear Feet Treated ❑ If this box is checked, then Final Perimeter treatment has been completed and the following statement is applicable: Certificate of Compliance: This building has received a complete treatment for the prevention of subterranean termites. This treatment is in accordance with the laws and rules established by the Florida Department of Agriculture and Consumer Services. l E.. CSC 1`tiO3-) Applicator's Name (please print) HES-TE019 10/11 Hulett 2011