HomeMy WebLinkAboutTermite Treatment7670 Okeechobee Blvd., West Palen Beach, Fl. 33411
Phone: 1-600-265-7376 Fax® 561-664-0122
Property Information
Builder Contractor
TreatmentDate A/ 2'� Time .0�
(no,
Name of Builder
Lot Block
Subdivision Name
Shell Contractor
Street Address (If known)
Construction Type
aMonolithic ,Jl' loating/Stemwall OPatio
City State zip
OEntry ®Driveway OOther:
Owner's Name (If known)
Product/Treatment Information
Treatment Type: IJUnderslab
❑ Patio/Driveway/Entry LAFinal
❑ Wood Treatment
❑ Bait System ❑ Other
Product: ❑ Disodium Octaborate
❑ Cypermethrin
❑ Imidacloprid
❑ Bifenthrin
❑ Permethrin
r /
.i�Other:
Concentration l) Zp
Mixed Product Applied S�
Square Feet Treated
Linear Feet Treated_
MIf 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.
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j1 /
Applicator's Name (please print)
Applicator's Signature
HES-TE019 11 /20
Hulett Environmental Services® 2020