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Home My WebLink AboutPRE-CONSTRUCTION TERMITE TREATMENTPre- Construction dMI(Ill"I'Termite Treatment A, C[IIVIII'0111 7670 Okeechobee Blvd., West Palm Beach, FI. 33411 Phone: 1-800-285-7378 Fax: 561-684-0122 Property Information Builder/Contractor n. Treatment Date i I p Time Name of Builder ;�sL• of Block Subdivision Name Shell Contractor y. Street Address (If known) Construction Type City State zip "~[]Monolithic []Floating/Stemwall OPatio Owner's Name (If known) []Entry ODriveway []Other: �.y.: Product/Treatment Information TreatmentJyppe 0 Underslab ❑ Patio/Driveway/Entry ❑ Final ❑"Wood Treatment ❑ Bait System ❑ Other Product: ❑ Disodium Octaborate ❑ Imidacloprid ❑ Permethrin Concentration F Square Feet Treated ❑ Cypermethrin ❑ Bifenthrin ~�0 Other: 1�� re arl 2 Mixed Product Applied 9,3o Linear Feet Treated ❑ 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 termites. This treatment is in accordance with the laws and rules established by the Florida Department of Agriculture and Consumer Services. Applicator's Name (please print) l Applicator-'s Signature HES-TE019 02/14 Hulett Environmental Services© 2015