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• Whitefly Treatment Inc. 4293 SW High Meadow Ave.
• Licensed & Insured �1° J6175775 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 � FI NTT SERVICE I TE MITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE �� - I TIME +� ((11jjII rP
DEVELOPMENT NAME (PROJECT) k� CONTRACTOR'S NAME .�1. ��, Y CONTACT PERS ° N
azn
STRUCTURE ADDRESS (LOT/BLOCK)) \v�� CITY, STATE COUNT
NOTES Ptr�> %�� ZIP CODE
TREATMENT TYPE/AREA
❑ FLOATING ❑ MONOLITHIC
❑ CUTOUTS ❑ F OTER
CI TAMP & TREAT TREAT ONLY
PATIO
❑ FRONT ENTRY
El FINAL
❑ GARAGE ❑ DRIVEWAY ❑ STEM WALL/FOOTERS ❑ ADDITION
❑ RETREAT ❑ BORA CARE TREATMENT ❑ PLUMBING CUT OUTS l7 SIDEWALKS
POOL DECK 0 OTHER
PRODUCTS
❑ BASELINE 8 DOMINION 2LACTIVE INGREDIENT ❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE ❑ TALSTAR
El OTHER
ACTIVE INGREDIENT
CONCENTRATION
itr IMIDACLAPRID ❑ BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
U .06% ❑ .1% ❑ .12% ❑ 25% 05% ❑ 23% ® 9% LJ OTHER
SQUARE FOOTAGE G LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED
YES ❑ NO
@°MEASURED OR VERIFIED PER PLANS
JOB EADY CONDITIONS MET
YES ❑ NO
DETAILS
GALLONS APPLIED ,3 t o
"Certificate of Compliance"
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.) er, O�
If this notice is for the final exterior treatment, initial and date this line
FINAL STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER
❑ OTHER
Payment Terms; Payment due at time of service.
Date
/e6Z
Date
Applicator: (Evict A Bug Termite and Pest Control, Inc.)
a t=
Customer (Property Owner or Agent)
www,evictabugpestcontrol.com