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Notice of Preventative Treatment for Termites
(as required by Florida Building Code (FBC) 104.2.6, 105.10 & R318.1 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIRE /ANT SERVICE I TERMITE SERVICE I RODENT EXCLUSION & REMOVAL I WHITEFLY TREATMENT
DATE OF SERVICE L) _nL TIME
DEVELOPMENT NAME (PROJECT) CONTRACTOR'S'NAME CONTACT PERSON (
r �,F�/J li >M J C <� �,J �'
„STRUC UREAE6RESS (LOTIBLOC ) ` CITY, STATE COUNTY
NOTESr ZIP CODE
TREATMENT TYPEIAREA — 7 1 11 _ I Alai
❑ FLOATING ❑ MONOLITHIC ❑ PATIO ❑ GARAGE ❑ DRIVEWAY ❑ STEM WALLIFOOTERS ❑ ADDITION
❑ CUTOUTS ❑ FOOTER ❑ FRONT ENTRY ElRETREAT ElBORA CARE TREATMENT ❑ PLUMBING CUT OUTS ❑ SIDEWALKS
❑ TAMP & TREAT 17-TREL
AT ONLY l=1•FINAL ❑ POOL DECK ❑ OTHER
PRODUCTS
❑ BASELINE
❑ OTHER
ACTIVE -INGREDIENT
CONCENTRATION
❑ .06% !❑ .1%
SQUARE FOOTAGE_
s a/—
11111DOMINION 2LACTIVE INGREDIENT ❑ TERMIDOR SC ❑ BORACARE ❑ PREMISE ❑ TALSTAR
O-IMIDACLAPRID '❑BIFENTHRIN ❑ DISODIUM OCTABORATE TETRAHYDRATE
❑ .12% ❑ .25% 0 :05% ❑ 23% El9% ElOTHER GALLONS APPLIED
LINEAR FOOTAGE 370
SQUARE FOOTAGE VERIFIED
I%ES ❑ NO
JOB READY CONDITIONS MET
OYES ❑ NO
O MEASURED OR VERIFIED PER PLANS
DETAILS
iscertificate of Compliance"
As per 104.2.6,105.10 & R318.1 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 w
FINAL STICKER t
tO ELECTRICAL PANEL ❑ WATER HEATER ❑ OTHHER
PaymentTerms: Payment
due at time of service. g �:
Date
ZZ
Date
Applicator: (Evict A Bug Termite and Pest Control, Inc.)
/ M ('� box
Customer (Property Owner or Agent)
www.evictabugpestcontrol.com