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Notice of Preventative Treatment for Termites
(as required by Florjda Building Code (FBC)104.26 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE ANT SERVIC
I TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
c�
DATE OF SERVICE' 1 '/ TIM-IUfZC
DEVELOPMENT NAME (PROJECT)
RACT NA
TCONTACTr(SON
PA&
STRUCTURE ADDRES9 (LOT/BLOCK)
IC
CITY, STATE, ZIP CODE
i
COUNTYV
NOTE
sec l-I I a� 0L-10
TAT-L`1
TREATMENT TYPE/AREA
❑ FLOATING ❑ MONOLITHIC ❑ PATIO
❑ GARAGE ❑ DRIVEWAY
❑ STEM WALLIFOOTERS
❑ CUTOUTS ❑ FOOTER ❑ FRONT E
TRY ❑ RETREAT ❑ BORA CARE TREATMENT ❑ PLUMBING CUT OUTS
El TAMP & TREAT TREAT ONLY i< FINAL
❑ POOL DECK ❑ OTHER
❑ ADDITION
PRODUCTS
.BASELINE ❑ DOMINION 2LACTIVE INGREDIENTBIFENTHRIN
❑ TERMIDOR SC
❑ BORACARE
❑ OTHER
ACTIVE INGREDIENT
❑ DISODIUM OCTABORATE TETRAHYDRATE
CONCENTRATION
; -16°% ❑ ,12% ❑ .25% ❑ .05°% ❑ 2
% ❑ 9°% t7 OTHER
GALLONS APPLIED /
SQUARE FOOTAGE
LINEAR FOOTAGE Z2.
5
SQUARE FOOTAGE VERIFIED
YES ❑ NOIEASURE
OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
kAYES El NO DETAILS
Asper 104.2.6 FBC -if soil chemical barrier method for termite prevention is used. Final exteriar treatment shall be completed prior to final building approval.
Certificate of Compliance• The building has received a complet I treatment for the prevention of subterranean termites. Treatment is in accordance with rules and laws established
by the Florida Department of Agriculture and Consumer Servicesi(Perthe Florida Building Code.)
If this notice is for the final exterior treatment, initial and date this line -eL
FINAL STICKER yy���p
❑ ELECTRICAL PANEL ❑ WATER HEATER { 'OTH R j?,--h
Payment Terms, Payment due at time of service. , I
Date pf to4 (Eyjt;t'A Buk'feurfile and
Date
Owner or Agent)
I
r3Qg-oZ,0
COUNTY
F •L• O R i D A
ig & Development Services
& Code Regulation Division
2308°Irginia Ave
Fort Pierce, FL 34982
i2-2172 Fax 772-462-6443
OF TERMITE TREATMENT
TION SOIL TREATMENT
PERMIT #: JOB ADDRESS
BUILDER/CONTRACTOR: i ,M.A,Ae[
PEST CONTROL CONTRACTOR: •' -
PEST CONTROL LICENSE #: -,&% 1 ti S `7
We, the undersigned, hereby certify that
subterranean termites in accordance wit!
Square feet if area treated:.22.�� X
Percentage of solution:
Date of Treatment: �?-
Footing
1s` Treatment
Re -Treat
Driveway
I�Treatment
Re -Treat
Other
1 Treatment
Re -Treat
ve have pretreated the above described construction for
the standards -of the National Pest Control Association.
Chemicals used:
A,
Total gallons used. -
Time of Treatment: l
Slab
1 Treatment
Re -Treat
Pools
14 Treatment
Note: There must be a completed form for each required tmatmefitorre-treAyfentand th/sform must be on the job
site to be picked up by the inspector at time bfeach inspection or the scheduled Inspection vvlll fail and a•re-inspection
fee charged.6
FBC104.2.6 Cerlfficate of Protective 760fntforprevention oftermites A weatherreststantjobske p051Y779 board
shall be provided to receive dupilcate Treatment Certificates as each required protective ireabhtentIs Completed,
providing a copy for the person the pemmit i-issued to and another copy the building permit files The Treatment
Certificate shall provide the productused, identity of the applicator, Gme and date of the treatment site /oration, area
treated, chemical used, percent concentraiio} and number ofgallons used, to establish a verifiable record of
protective treatment .If the soil chemical ba�,armethod for termite prevention Is used, final a eriortieatmentshall
be completed prior to final -bulli ing approvah
St Lucie County requires for the final inspection for CO, a Permanent Sticker to be placed on
the electrical panel box cover, listing all the treatments,.and dates of applications.
521 NW Enterprise Drive • Port St. Lucie, Fforr'da 34986
(772)924-3575 • (772)924-3580 (fax)
c
IN -PLACE DENSITY AND WATER CONTENT OF SOIL AND SOIL
AGGREGATE BY NUCLEAR METHODS (SHALLOW DEPTH) - ASTM 6938
Project: Masterpiece Builders - Various Projects Project ID: 13-2000.00'
Address: Various Projects Report ID:, D-0002
Client: Masterpiece Builders Date: 11/1/2013
Permit No: N/A Field Tech: Mark Barkley Test Mode: Direct Transmission
Area Tested: 4900 Watersong Way, Fort Pierce - Foundation Pad
Soil Description: Gray fine sand
Proctor / LBR ID: P-1 Max Density (PCF): 108.0 Opt Moisture (%): 11.0% Test Standard: D 1557
Compaction Required (%): 95.0%
Probe
Depth
(in)
Elev
Wet
Density
(PCF)
Dry
Density
(PCF)
Moist.
(%)
Compaction
Location
°
/°
Results
Northeast Corner
12
0 - .1
112.4
103.6
8.5%
95.9%
Pass
Center Area
12
0-1
113.7
104.1
9.2%
96.4%
Pass
Southwest Corner
12
0-1
112.5
103.9
8.3%
96.2%
Pass
Testing Gauge Information: Manufacturer: Troxler Model: 3430 S/N: 34151
Density Standard (DS): 2044 Moisture Standard (MS):_
Remarks: Depths are below slab arade. ..e0�'°`tt I aI1°pees
Lena Tor tlevation:
= Proofroll
= Springline
= Subgrade
= Basecourse
P = Top of Pipe
1, 2, 3 = 1 st, 2nd, 3rd Lift
FL = Final Lift
BG = Below Grade
BOF = Bottom of Footing
FG = Finished Grade
o TAPE
Test report shall not be reproduced, except in full, without the written approval of GFA Internationals
679
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9--13
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