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HomeMy WebLinkAboutTermite Treatment ( 2)cnvironm�ntal ;S�'.`rWiCCS Pre -Construction Termite Treatment s A 7670 Okeechobee Blvd., West Palm 'Beach, FI. 33411 Phone: 1-800-285-7378 Fax: 5614i84-0122 Property Information Treatment Date lP eC Time t PA - Lot Block V erVP0,Q Subdivision Name 1:3-13-?C( NW Street Address (If known) city.,", State Zip Own6r's Name (If known) Builder/Contractor Name of Builder Shell Contractor Construction Type M, onolithic OFloating/Stemwall OPatio DEntry ODriveway DOther: Product/Treatment Information Treatment Type: ❑ Underslab ❑ Patio/Driveway/Entry Q' inaF 1 Wood Treatment ❑ Bait System ❑ Other Product: ❑ Disodiu Octaborate ❑ Cypermethrin ®' mi1� dacl Arid ❑ Bifenthrin tp 71 Permethrin ® ❑ Other: Concentratioii , ®� T Square Feet Treated g Mixed Product Applied Linear Feet Treated oQ 3 L7 If is box is�'checked, then Final Perimeter treatment:has completed ano:the following statement is .applicable: Certificate of Compliance: This. building has, received a domplete treatment for the prevention of subterranean termites. This treatment is in accordance ith the laws and rules established by the Florida Department of Agriculture and Consumer Servo.' Applicator's Name ,(please print) Applicator's ignature HES-TE019' 02/14 Hulett l nv mental ervices© 2014 q