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Home My WebLink AboutTERMITE TREATMENT CERTIFICATEP- Planning & De—veloprient-Services r 1I r t " Building & Code Regulation Division p 2300 Virginia Ave • Fort Pierce, FL 34982 772-462-2172 Fax 772-462-6443 SCANNED BY CERTIFICATE OF TERMITE TREATMENT St. Lucie County --CONSTRUCTION-SOIL CONSTRUCTION -SOIL TREATMENT PERMIT #: /D /- 0543 JOBADDRESS: 44,Z9 AU RWY 7 t BUILDER/CONTRACTOR: -A2TA9 CW-37AVOTr0J GGc Aeny,0o /24�'r156 ` 06A% PEST CONTROL CONTRACTOR: fir :6/7 PEST CONTROL LICENSE #: ,JF 2LYI /3 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. Square feet if area treated: yTJ D Percentage of solution: v G 79 Date of Treatment: b 11 /I Footing 15` Treatment Re -Treat Driveway 1't Treatment Re -Treat Other 1st Treatment Re -Treat Chemicals used: �lir M 'Ay 4F- Total gallons used: G7� Time of Treatment: /o:/3— _Slab 1't Treatment Re -Treat Pools 1st Treatment Re -Treat Perimeter for Final Iction ILK Signature of Exterminator Date Note: There must be a completed form for each required treatment or re -treatment and this form must be on the job site to be picked up by the inspector at time of each inspection or the scheduled inspection will fail and a re -inspection fee charged. FBC104.2.6CertificateofProtectiveTreatmentforprevenbonoftermites. Aweather resistantjobsitepostingboard shall be provided to receive duplicate Treatment Certificates as each required protective treatment 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 be completed prior to final building approval. St Lucie County requires for the final inspection for CO, a Permanent Sticker to be placed on the electrical panel box cover, listing all the treatments and dates of applications. Revised 7/24/2014 Customer Address A Phone t�i��`3��JContract # -------------------------------------------------------- Terminix Address r96 III) I city- flr� S /j / j-Gt)L State FL zip 2�m Telephone 9-}2 —3 V0 o U jam' TEANMINIX 11 > Application and TeRecor® Insulation Service Record Date of Application �O(�/ /, n/A� Timef) r In Po? Time Out . "7, � Applicators)/Certif.# ✓��yy`��A"�f1PS-� —`ff� yc3 a�a�j Supervisor/Certif. # z G. Y 1—t7 ��IO�QfI �Wj�2 ❑ Original Treatment ❑Retreatment /F7 Pretreatment ❑ Complete Treatment ❑ Limited Treatment ❑ Perimeter ❑ Attic Insulation ❑ I 'Wind Speed �(P'! •MPH from the (direction) �/ t Target Pest l7'Subterranean Termites ❑ DrywoodTermites ❑ Old House Borers ❑. Powderpost Beetles ❑ Wood Decay Fungi ❑ Product Applied Chemical Manufacturer EPA# % Applied Cl AlpineTermite Foam Dinotefum BASF 499-526 ❑ 0.025% ❑ BoraThor Max PT Disodium OctabomteTetrahydrate Ensystex II, Inc. 81824-11 ❑ 9% ❑ 13 % ❑ 16% ❑ 23% ❑ BoraThor SP Disodium OctabomteTetrahydrate Ensystex II, Inc 81824-8 ❑ 10% ❑ 15% ❑ Sora-Care Disodium OctaborateTetrahydate NISUS 64405-1 ❑ 9% ❑ 13°% ❑ 16% Cl 2391. ❑ Fast Out CS Foam Cylluthrin BASF 499-523 ❑ 0.1 % ❑ Phantom (SC) Chlorfenapyr BASF 241-392 00.125% ❑0.25% ❑ Premise Pre -Construction Imidacloprid Bayer 432-1331 ❑ 0.05% ❑ Termidor SC(SC) Fipronil BASF 7969-210 00.06% 00.125% ❑ Termidor 80(WG) FlI nil BASF 7969-209 ❑0.06% ❑0.125% ❑Tm-Bor (SP) Disodium OctaboateTietahydrate NISUS 64405-8 ❑ 10% ❑ 15% ❑AdvanceTermite Bait Diflubenzumn BASF 499-500 ❑0.25%(124gm) ❑ Recruit HD IkC Noviflumuron }}nronf_� D W Y��F 62 19-608 `�b -3?- ❑ 0.5% 2,5 :11z.vb,.P0 The following is by Corporate approval only: ❑ Prelude (EC) Pennethrin Syngenta 100-997 ❑ 0.5% ❑ 1 % ❑ 2% ❑ T.A.P Insulation Orthoboric Acid Pest Control Insulation 72787-1-83896 ❑ 11.1 % ❑ 12.5% ❑ `Gas Engine ❑ *Electric motor 'Diaphragm Pump ❑'Piston Pump ❑ •25 PSI or less at nozzle ❑ •50 PSI or less at nozzle ❑_•PSI at pump ❑ _•PSI at pump ❑ *Hand Duster ❑ *Aerosol Injection ❑ *Compressed Air Sprayer ❑ AreasTreated: ❑ See Below X7 ee Contract Graph ❑ See Attached Graph Amount oz _gal gal gal oz _gal gal gal gal gal ea ea _ gal 30# bags Formulation A=Aerosol B=Bait D=Dust EC=Emulsifiable Cone. F=Foam SC=Suspendible Cone. SL=Soluble Liquid SP=Soluble Powder WG=Water Dispersible Granules *Application Rate ❑ 4 gal/10 linearft ❑ 2 gaV10 linearft gal/10 square It ❑ 1.5 gat/10 square ft ❑ _/ ❑ Applied at less than label rate ❑ Monitoring Stations only (no bait) ❑ *Roller Pump ❑ *In -Line Injection System ❑ Insulation Blower Description of AreasTreated Zvi J Sc, i X . /rc�S4 Z Z_.S ® r / (� t��/ (!om r> vt y Pike tk JN LN Control Services have Activity �� - Dean performed on my property to my satisfactidn. Customer n el Termite Technician �%�^� �Y` 6 Y/� Notice of Treatment was posted at or near y Date Posted Manager ❑ Electric Breaker Box ❑ Water Heater Closet Bookkeeper ❑ Bath Trap Access ❑ Beneath the Kitchen Sink O 2013ThaTerminix International Company Limited Partnership. All rights reserved. Key #31117 Rev. 3113 *Complete where applicable.