HomeMy WebLinkAboutPRE-CONSTRUCTION TERMITE TREATMENT3GAN E
Pre -Construction
t. Lucie co ri
1 7LETT Termite Treatment
avivonrnental
services
i 7670 Okeechobee Blvd., West Palm Beach, FI. 33411
Phone: 1-800-285-7378 Fax: 561-684-0.122,
Proper . Information
Builder/Contractor
Treatment Date � �,�!� Time
asp
Name of Builder
of `Ll. 1 Block
ubdivision Name
1
Shell Contractor
treet Address (If known)
r I �
Construction Type
r S
ity State Zip
OMonolithic OFloating/Stemwall OPatio
FlEntry ODriveway Other:64,
wner's Name (If known)f...l�
i
I
Product/Treatment Information
Treatment Type: ❑ Underslab ❑ Patio/Driveway/Entry ❑ Final
Wood Treatment ❑ Bait System ® Other
CProduct: ❑ Disodium' Octaborate ❑ Cypermethrin
'I Q Imidacloprid 0 Bifenthrin
Permethrin ❑ Other:
Concentration I Mixed Product Applied
Square Feet Treated U Linear Feet Treated
If this box is checked, then Final Perimeter treatment has
:3n completed and the following statement is applicable:
;rtificate of Compliance: This building has received a complete treatment for the prevention of
bterranean termites. This treatment is in accordance with the laws and rules established by the
or, ida Department of Agriculture and Consumer Services.
1
Applicator's Name (please print) Applicator's Signature
S-TE019 1'2/21 Hulett Environmental Services0 2021'