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Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
(K G
PERMIT #: I'LO . 00-10- JOB ADDRESS:
BUILDER/CONTRACTOR: 7 ' A A.✓'.�
PEST CONTROL CONTRACTOR: /
PEST CONTROL LICENSE #��2%-/ -- -_ -- -- ----
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.
SI C} r- ter+
quare feet'if area treated: l a Chemicals used: & � ,q
Percentage of solution: Total gallons -used:
Date of Treatment: k7 Time of Treatment: r
i
Footing
1 Treatment
Re -Treat
Driveway
1 Treatment
Re -Treat
� Other
1StTreatment
Re -Treat
t Slsl -
1� Treatment
Re -Treat
Pools -
P Treatment
Re -Treat
Perimeter for Final Inspection
Signature of Exterminator
e: There must be a completed fonn for each required treabnent or re -treatment and this form must be on the job
to be picked up by the inspector at time -of each inspection or the scheduled inspection will fail and a re -inspection
charged.
FBC104.2.6 Certificate of Protective Treatment for prevention of termites A weather msislant jobsite gosling board
shall be provided to receive duplicate Treatment Certificates as each required protective beatment 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
bel completed prior to frrral building approval.
St Lucie County requires for the final inspection for CO, a Permanent Sticker to be placed on