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Je5u5
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free:1-811385-9999
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faX: 772-340-5909
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• Whitefly Treatment
Inc'
4293 SW High Meadows Ave.
• Licensed & Insured
Lic. JB175775
Palm City, FL 34990
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 PREVENTION I FIRE ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE
TIME
DEVELOPMENT NAME (PROJECT) CONTRACTOR'S NAME CONTACT PERSON
STRUCTURE ADDRESS (LOT/BLOCK) CITY, STATE COUNTY
NOTES ZIP CODE
TREATMENT TYPE/AREA
❑ FLOATING ❑ MONOLITHIC ❑ PATIO ❑ GARAGE ❑ DRIVEWAY ❑ STEM WALUFOOTERS ❑ ADDITION
❑ CUTOUTS ❑ FOOTER ❑ FRONT ENTRY ❑ RETREAT ❑ BORA CARE TREATMENT ❑ PLUMBING CUT OUTS ❑ SIDEWALKS
❑ TAMP & TREAT ❑ TREAT ONLY ❑ FINAL ❑ POOL DECK ❑ OTHER
PRODUCTS
❑ BASELINE
❑ OTHER
ACTIVE INGREDIENT
CONCENTRATION
❑.06% ❑.1%
SQUARE FOOTAGE _
❑ DOMINION 2LACTIVE INGREDIENT ❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE ❑ TALSTAR
❑ IMIDACLAPRID ❑ BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
❑ .12% ❑ .25% ❑ .05% ❑ 23% ❑ 9% ❑ OTHER
SQUARE FOOTAGE VERIFIED
❑ YES ❑ NO ❑ MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
❑ YES ❑ NO DETAILS
LINEAR FOOTAGE
GALLONS APPLIED
"Certificate of Compliance"
As per l04.2.6,105.10 & 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
FINAL STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER ❑ OTHER
r
Payment Terms: Payment due at time of service.
Date
Applicator: (Evict A Bug Termite and Pest Control, Inc.)
Date
Customer (Property Owner or Agent)
www.evictabugpestcontrol.com