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HomeMy WebLinkAboutPRE-CONSTRUCTION TERMITE TREATMENTQ.,, HUL�ra� cnvironmcaal:al Sa�rWaC4`c Pre -Construction °Y 6� 7670 Okeechobee>,Blvd.,, West Palm Beach, _F1 33411 Phone: 1 800-285-7378 Fax: 561-684-0122 Termite Treatment Property Information Treatment Date / i' Time �.GC Lot Subdivision Name Block Builder/Contractor Name of Builder Shell Contractor Street Address (If known) Construction Type . City State zip []Monolithic OFloating/Stemwall OPyatio''` r Owner's Name (If known) []Entry ODriveway []Other: ` Product/Treatment Information Treatment Type: 0 Underslab Wood Treatment Product: ❑ Disodium Octaborate P I-Qacloprid 0 Permethrin Concentration . OJ__ Square Feet Treated 71 Patio/Driveway/Entry ©Tinal Bait System ❑ Other 13 Cypermethrin /. 71 Bifenthrin r 71 Other: Mixed Product Applied Linear Feet Treated - 2% / f7r"I`fthis 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. •..� as oti. eS G f'c..h a. � ,. Applicator's Name (please print) HES-TE0.1'9 02/14 Applicator's. Signature Hulett Environmental Services cp 2014