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HomeMy WebLinkAboutTermite Treatment (2) VC Pre-Construction envi env3 ronmental TLETT Termite Treatment services 7670 Okeechobee Blvd., West Palm Beach, F1. 33411 Phone: 1-800-285-7378 Fax: 561-684-0122 Property Information Builder/Contractor Treatment Date �l`''hj �. Time I s c Z"!JJ G RECEIVED Name of Builder Lot � Block SEP 13 2021 St.Lucle County Subdivision Name Permittina — Shell Contractor 1n`00(\ Ave _Street Address TIf known) Construction Type 4or� Q',or((, FL �ySS I City state _ Zip ❑Monolithic ❑Floating/Stemwall []Pa- Lo n do Owner's I'('e o `��n) o� l ti ❑Ent ❑Drivewa DOther: M"-. V 0,r-.e _Owner s Name (If known) rY Y i Product/Treatment Information Treatmentyp .T e• ❑Underslab ❑Patio/Driveway/Entry ❑Final ❑Wood Treatment ❑Bait System ❑Other i Product: ❑Disodium Octaborate ❑Cypermethrin ❑Imidacloprid ❑Bifenthrin ❑Permethrin ❑Other: (,If;-,Ao-r SC Concentration `d Mixed Product Applied Square Feet Treated Linear Feet Treated d 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 establis,ed by the Florida Department of Agriculture and Consumer Services. Applicator's Name (please print) Applc tors ignature HES-TE019 08/16 I Hulett Environmental Services©2016 . ,