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HomeMy WebLinkAboutPRE-CONSTRUCTION TERMITE TREATMENT 10-18-16Pre- Construction L"I SCAN f1 E Termite Treatment., e�CounY), . . 7670 Okeechobee Blvd., West Palm Beach, FI. 33411 Phone: 1-800-285-7378 Fax: 561-684-0122 Property Information L�Treatment Date Time Lot Block R" ✓Pr L) j Subdivision Name 0 0 Aajd'14� , Way Street Address (If known) City State Zip Owner's Name (If known) Builder/Contractor Name of Builder Shell Contractor Construction Type *onolithic []Floating/Stemwall ❑Patio ❑Entry []Driveway ❑Other: Product/Treatment Information Treatment Type: ❑ Underslab ❑ Patio/Driveway/Entry Final ❑ Wood Treatment ❑ Bait System ❑ Other Product: ❑ Disodium Octaborate ❑ Cypermethrin Imidacloprid p /q ej' ^' Z ❑ Bifenthrin ❑ Permethrin ❑ Other: Concentration , of Square Feet Treated Mixed Product Applied %S Linear Feet Treated 2 ❑ If this 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 to mites. ffiis treatment is in accordance with the laws and rules established by the Florida Depar , ent o�Mriculture and Consumer Services. 's Xarife (please print) App icator's S' ature HES-TE019 07/14 v Hulett Environmental Services© 2014