HomeMy WebLinkAboutPRE CONSTRUCTION TERMITE TREATMENT CERTIFICATE_r Pre -Construction
Termite Treatment
environmental
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7670 Okeechobee Blvd., West Pa1m�B.each, F1. 33411
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Phone: 1 800-285-7378 Fax:' 561-684-0122
Property Information
Treatment Date G?// 7 6— Time
L„ot Block
die -' l .ate" a
Subdivision Name
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�7009 . A,/j') I0Gdr I" e
Street Address (If known)
?S� F1`/ 797
Cip;ty State Zip
Name (If known)
Builder/Contractor
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Name of Builder
OkZuder,
Shell Contractor
Construction Type
E[lonolithic OFloating/Stemwall OPatio
OEntry ODriveway OOther:
Product/Treatment Information
-ill
Treatment Type: Q Underslab ❑ Patio/Driveway/Entry ❑ Final
i ❑ Wood Treatment ❑ Bait System ❑ Other
I,
11
Product: ❑ Disodium Octaborate
0 Imidacloprid
I:
❑ Permethrin
Concentration /® a co
Square Feet Treated 41f -71
❑ Cypermethrin
❑ Bifenthrin
13 Other:
Mixed Product Applied 0 1 %
Linear Feet Treated
0 !if this box is checked, then Final Perimeter treatment• has
been completed and the following statement is applicable:
I .
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) / pplicator's Signature..;•:
HES'-TFA19 09/12 Hulett Environmental' S ' i66,0 2012