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HomeMy WebLinkAbouttermite pre constructionPre -Construction oxxxna]< Termite Treatment a :;cruiccs 7670 ®ksa6hobee Blvd., West Palm Beach, FI. 33411 Phone. �-800-285-73718 Fax: 561-684-C 122 Property Information Treatment Date c % ` —- Time Lot Subdivision Name _Street Address (If known) Block _ city State Zip J Owner's Name (If known) Builder/Contractor Name of Builder Shell Contractor Construction Type O'1Vlonolithic ❑Floating/Stemwall []Pa- tio [] Entry []Driveway [] Other: Product/Treatment Information Treatment Type: ❑ Underslab ❑ Wood Treatment Product: ❑ Disodium Octaborate 0" Imidaeloprid ❑ Permethrin Concentration Square Feet Treated ❑Patio/Driveway/Entry ❑ Final ❑ Bait System ❑ Other ❑ Cypermethrin ❑ Bifenthrin ❑ Other: Mixed Product Applied i I • /,� Linear Feet Treated ❑ 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 established by the Florida Department 1of Agriculture and Consumer Services. 7. Applicator's Name (please print) '` Applicator's Signature HES-TF019 08/16 Hulett Environmental Services© 2016