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HomeMy WebLinkAboutPre-Construction Termite Treatment- o/ s �,m Pre- Construction H,UI.ETT Termite Treatment ' cnvir�nmental scrviccs 7670 Okeechobee Blvd., West Palm Beach_, F1. 33411 Phone: 1-800-285-7378 Fax: 561-684-0122 Property Information Treatment Date Time Lot Block Subdivision Name Street Address (If known) City State Zip Owner's Name (If known) Builder/Contractor 1- 4 LYE/L 011W A"' Name of Builder -$;g � Shell Contractor Construction Type Monolithic OFloating/Stemwall OPatio OEntry ODriveway OOther: Product/Treatment Information Treatment Type: E Underslab. Wood Treatment Product: �❑ DDi�isodium Octaborate L midacloprid ❑ Permethrin ,Concentration / Square Feet Treated 7Tr,4r ❑ Patio/Driveway/Entry ❑ Final Bait System ❑ Other ❑ Cypermethrin ❑ Bifenthrin ❑ Other: Mixed Product Applied Linear Feet Treated / /a 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) App ' s Signature HES-TE019 09/12 Hulett Environmental Services© 2012 j