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Notice of Preventative Treatment for Termites
(as required by Florida Building Code(FBC) 104.2.6 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION&REMOVAL I VVHITEFLY TREATMENT
DATE OF SERVICE "J '. E TIME
DEVELOPMENT NAME(PROJECT. CO�JTRACTOR'S NAME CONTACT PERSON
STRUCTURE ADDRESS(LOT/BLOCK) CITY,STATE COUNTY
Lz 3 2 I I-c-A'I 1 �.,, \ ZIP CODE J
NOTES (( 2 LI(71 Q
— roc,
TREATMENT TYPEIAREA ❑STEM WALL/FOOTERS ❑ADDITION
�,
❑FLOATING )0',MONOLITHIC ❑PATIO ❑GARAGE #DRIVEWAY ❑PLUMBING CUT OUTS O SIDEWALKS
❑ ❑ ❑ ❑CUTOUTS FOOTER FRONT ENTRY RETREAT ❑BORA CARE TREATM• ENT
❑TAMP&TREAT 4TREAT ONLY FINAL ❑POOL DECK 90THER PRODUCTS ( [ITALSTAR
El BASELINE fOJ DOMINION 2LACTIVE INGREDIENT ❑TERMIDOR SC ❑BORACARE ❑PREMISE
❑OTHER
IJVIIDAGLAPRID O,B`ENJ IIIO ODIUM CC E TET t 1YQRATE
ACTIVE INGREDIE.Ni N — a^' r '' r r,Nr 1 Fy�Kf s�4r' 'Yf ii
CONCENTRATION
GALLONSAPPLIED S
1
❑.06% �1% ❑.12% ❑.25% ❑.05% ❑23% 0:9% ❑OTHER LINEAR FOOTAGE t7
SQUARE FOOTAGE � �
SQUARE FOOTAGE VERIFIED
'0 YES ❑NO KIMEASURED OR VERIFIED PER PLANS
W_--
JOB READY CONDITIONS MET
4 YES
❑NO DETAILS
nal
l.
qs per 104.2.E FBC-If soil chem
ical barrier method for termite prevention is used.Final exterior treatment shall be completed prior m scan dance withprova
e of Com liance:The building has received a complete treatment for the prevention of subterranean termites.Treatment
ules
,ertificat o —
established by the Florida Department of Agriculture and Consumer Services.(Per the Florida Building Code.)
and laws
f this notice is for the final exterior treatment,initial and date this line
=1NAL L3 WATER HEATER ❑OTHER
ELECTRICAL PANEL
Papa mew Payment due at time of service. /
Applicator:The Bug Asirts,LLC
E11
Date
0t C,✓1
�i
Customer(Property Owner or Agent)
Date