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HomeMy WebLinkAboutTermite Treatment k F Pre-Construction TermiteTreTreatmentenvirol-irnexital . ' services 7670 Okeechobee Blvd.,,West Palm Beach, FI. 33411 Phone: 1-800-285-7378 Fax: 561 -684-0122 Property Information !l /J Builder/Contractor Treatment Date 11 o S-2� Time d• ,V Lot Block Name of Builder Subdivision Name �i 1 I 1 l�- Shell Contractor G3� Pi ye r �AginIMOLK Y) _Street Address(If known) Construction Type city State Zip O'Monolithic OFloating/Stemwall []Pa- tio LiCA`nL'�- �'�J���'> f Owner's Name (If known) OEntry .ODriveway OOther: i_ Product/Treatment Information Treatment Type: ❑Underslab 0 Patio/Driveway/Entry ❑Final ❑Wood Treatment ❑Bait System ❑Other Product: ❑Disodium Octaborate ❑Cypermethrin 0 Imidacloprid ❑Bifenthrin Perimthrin ❑Other: Concentration ,06 Mixed Product Applied Square Feet Treated Linear Feet Treated 0 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 of Agriculture and Consumer Services. Applicator's Name (please print) �'rf Applicator's Signature HES-TE019 08/16 Hulett Environmental Services©2016