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Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC)104.2.6 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I�IIj FI E ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I VVHITEFLY TREATMENT
DATE OF SERVICE �D �i TIME
DEVELOPMENT NAME (PROJECT) CO RAC; T R'S NAM CONTACT PERSON
0 �,t`C u
STRUCTURE ADDRESS (LOTIBLOCK) CITY STATE COUNTY
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NOTES ZJP CODE
OVA? � '. 9 Gov 13Nl
TREATMENT TYPEIAREA
❑ FLOATING (MONOLITHIC ❑PATIO ❑ GARAGE ❑DRIVEWAY ❑ STEM.WALLIFOOTERS ❑ ADDITION
q CUTOUTS ❑ FOOTER ❑FRONT ENTRY ❑ RETREAT ❑ BORA CARE TREATMENT ❑ PLUMBING CUT OUTS ❑ SIDEWALKS
kTAMP&TREAT El TREAT ONLY El FINAL El POOL DECK ❑OTHER
ROP DUCTS
Cl BASELINE DOMINION 2LACTIVE INGREDIENT ❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE ❑ TALSTAR
❑ OTHER
ACTIVE INGREDIENT
CONCENTRATION
* IMIDACLAPRID 13 BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
❑ .06% 1% ❑ .12% (3.25019 - ❑ .05% ❑ 2N 138% ❑ OTHER GALLONSAPPLIED � �O
SQUARE FOOTAGE ! 1 LINEAR FOOTAGE
SQUARE FOOTAGE VERIFIED WMEASURtO
RYES ❑ NO OR` VERIFIED� PLANS
JOB READ CONDI S A
YES I ❑ NO DETAILS
As per 104.2.6 FBC - If soil chemical barrier method for termite prevention Is used. Final exterior treatment shall be completed prior to final building approval.
Certificate of Compliance: The building has received a complete treatment for the prevention of subterranean termites. Treatment is in accordance with rules
and laws established by the Florida Department,of Agriculture and Consumer Services. (Per the Florida Building Code:)
If this notice is for the final exterior treatment, Initial and date this line
FINAL STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER Cl OTHER
Payment Terms: Payment due at time of service.
A -Al 11,
Date
Date
Apppliic�attor. The Bug Assasssiins�LLCI
Customer (Property Owner or Agent)