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2300 Virginia Ave
Fort Pierce, FL 34982 Qec PQR c�gG �9
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #: 0 oS
BUILDER/CONTRACTOR:
JOB ADDRESS: �LgD
N," .6 U_'AA.9 S Z) j�7
PEST CONTROL CONTRACTOR: EVICT -A -BUG TERMITE & PEST CONTROL INC.
PEST CONTROL LICENSE #: J13175775
We, the undersigned, hereby certify that we have pretreated the above described construction for
subterranean termites in accordance with the standards of the National Pest Control Association.
Square feet if area treated: a45 a -
Percentage of solution: .05%
Date of Treatment: q 14 J>;k-
V--Footing
yC.ist Treatment
Re -Treat
Driveway
13t Treatment
Re -Treat
Other
1st Treatment
Re -Treat
Chemicals used: DOMINION 2L
Total gallons used:
Time of Treatment:
Slab
moist Treatment
Re -Treat
Pools
1st Treatment
Re -Treat
Perimeter for Final Inspection
Signature of Exterminator Dat
Note. There must be a completed form for each required treatment or re -treatment and this form must be on the job
site to be picked up by the inspector at time of each inspection or the scheduled inspection will fail and a re -inspection
fee charged.
FBC104.2.6 Certificate of Protective Treatmentfor.prevention of termites A weather resistantjobsiteposting board
shall be provided to receive duplicate Treatment Certificates as each required protective treatment is completed,
providing a copy for the person the permit is issued to and another copy for the building permit files The Treatment
Certificate shall provide the product used, identity of the applicator, time and date of the treatment, site location, area
treated, chemical used, percent concentration and number of gallons used, to establish a verifiable record of
protective treatment. If the soil chemical barrier method for termite prevention is used, final exterior treatment shall
be completed prior to final building approval.
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.
Revised 7/24/2014