HomeMy WebLinkAboutPre-Construction Subterranean Termite TreATMENT"Considering Your Environment" U 2�
State Licensq Number 114708
11192 47th Road North Royal Palm Beach, FL 33411
561-333-8777 / FAX 561-333-8999 / Toll Free 866-414-PEST
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Property Information
Subdivision: �TZ �G�✓62 �� �G �— Lot: Block: Section:
Address l ``1 c/ l �� �z-i, � L5
City & Zip
Owner
Name of Builder:
Shell Contractor:
Monolithic:
Driveway:
Addition:
Builder/ Contractor Information
Construction Type
Floating/Stemwall:
Other:
Patio: Entry:
Product / Treatment Information
Treatment Date: / I Time:/ ,i9 / `� Technician:
Treatment Type (rAst chea one) Initial Under Slab: 'Supplemental: _
Product Applied: Cype ethrin: Premise 75 Other
Concentration: % Mixed 2rbduct Applied: V,6n Gallons
Square Footage Treated: D' Linear Feet Treated: '
If this 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. TREATMENT IS IN ACCORDANCE WITH THE RULES AND
LAWS ESTABLISHED BY THE FLORIDA DEPARTMENT OFAGRICULTUREAND CONSUMER SERVICES.
(Florida Building Code (FBC)1816.1.7)
61
Applicators Name (Please Print) /�L�di✓
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State License Number 114708
11192 47th Road, North Royal Palm Beach, FL 33419
561-333-8777 / FAX 561-333-8999 / Toll Free 866-414-PEST
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Property Information
Subdivision: YA P-4%/A- P-N G ,C— Lot: Block: Section:
Address
City & Zip
Owner
Name of Builder:
Shell Contractor:
r/ f--- e
Builder / Contractor Information
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Construction Type
Monolithic: _)( Floating/Stemwall: Patio: Entry:
Driveway:
Addition: _ Other:
Product / Treatment Information
Treatment Date: i a Time: % Cam- Tec nician: N�-
Treatment Type ( st chick one) Initial Under Slab: Supplemental:
Product Applied: Cypermethrin: Premise 75 or
Concentration: a \ % Mixed Froduct Applied: N-O" Gallons
Square Footage Treated: �-v n W Linear Feet Treated:
If this 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. TREATMENT IS IN ACCORDANCE WITH THE RULES AND
LAWS ESTABLISHED BY THE FLORIDA DEPARTMENT OFAGRICULTUREAND CONSUMER SERVICES.
(Florida Building Code (FBC)1816.1.7)
Applicators Name (lease Print)
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