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Insulation Service Record
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Address
Date of Application
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TimeOut
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City />� 1-,_�� State. G Zip 3`-Pl9
Applicator(s)/Certif.#
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C/✓Y f�-Gqq'Ml-Gib-nnJ iJ Ze3oq`�
Phone Z'4-724 ✓S��Contract
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Supervisor/Certif. #
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,b Original Treatment
Retreatment ❑ Pretreatment
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Terminix Address L JD ry4&tr AXAI
,
❑Corap IeteTreatment
❑ Limited Treatment El Perimeter
Plus
city 4d Vi (� (,t, State Zip J� �
SCANNED
4t ri'
❑ Attic Insulation
❑
Telephone % Z `3 - /J O d y
'Wind Speed
'MPH from the (direction) St.
Lucie Comity -
Target Pest /11'subterranean Termites ❑ DrywoodTermites ❑ Old House Borers ❑ Powderpost Beetles ❑ Wood Decay Fungi
❑
Product Applied Chemical
Manufacturer EPA# %
Applied Amount
Formulation
❑ AlpmeTennite Foam Dinotefuran
BASF
499-526
❑0.025% 0z
A --Aerosol
❑ BoraThor Max Pr Disodium Octabomie latrahydrate
Ensystex 11, Inc.
81824-11
0 9% 013% ❑ 16% ❑ 23% gal
B=Bart
O BomThor SP Disodium OctaborateTetrahydrate
Ensystex 11, Inc
81824-8
010% ❑15%
D=Dust
O Bom-Care Disodium OctabomteTetmhydmte
NISUS
64405-1
_gal
❑9% 013% 016%023%
EC=Emulsifiable Conc.
El Fast Out CS Foam CyOuthdn
BASF
499-523
_gal
❑0.1% oz
F=Foam
SC=Suspendible Conc.
O Phantom (SC) Chlorfenapyr
BASF
241-392
00.125% 130.25% _gal
SL=Soluble Liquid
❑ Premise Pra-Construction Imidacloprid
Bayer
432-1331
❑ 0.05% gal
SP=Soluble Powder
❑ Tennidor SC (SC) Fipmnil
BASF
7969-210
(30.06% 00.125% gal
WG=Water Dispersible
❑Tennidor 80"G) Fpmnil
BASF
7969-209
❑0.06% ❑0.125% _gal
Granules
❑Tim-Bor(SP) Disodium OctabomteTetraVrate
NISUS
64405-8
❑10% 015% al
9
WP=Wettable Powder
❑AdvanceTennite Bait Diflubemumn
BASF
499-500
❑ 0.25% (124gm) ea
-❑ Recruit HD nn N�%:iflumumn ))
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6271j9-608
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❑ 0.5%a
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*Application Rate
❑ 4 gal/10 linear ft
❑2
r
gal/101mearft
❑
A I gal/10 square 1t
❑ 1.5 gal/10 square it
The following is by Corporate approval only:
,.
❑ /
❑ Prelude (EC) Permethrin
Syngenta
100-997
❑ 0.5% ❑ 1 % ❑ 2% gal
❑ Applied at less
than label rate
-
❑ Monitoring Stations
❑ TAP Insulation Orthoboric Acid Pest
Control Insulation
72787-1-83896 ❑ 11.1
_
% ❑ 12.5 % 304 bags
only (no bait)
❑'Gas Engine Cl *Electric motor
7U'Diaphragm Pump ❑'Piston Pump ❑ `Roller Pump ❑'In-Dne Injection System
❑ *25 PSI or less at nozzle ❑'50 PSI or less at nozzle 0_'PSI at pump ❑ _'PSI
at pump ❑ Insulation Blower
❑ `Hand Duster ❑'Aerosol Injection
❑'Compressed Air Sprayer ❑
hed Graph
Description of AreasTreated
/110 cia 4. X . 10 9
411si Mew
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been performed on my property to my satisfaction.
Customer IL4A,
Termite Technician • eFG 9 c( Y1 Ay � Notice of Treatment was posted at or near Date Posted
Manager ❑ Electric Breaker Box ❑ Water Heater Closet
Bookkeeper
❑ Bath Trap Access
02m3The1enn1nix International Company Limited Partnership. All rights reserved. Key #31117 Rev. 3/13
❑ Beneath the Kitchen Sink
`Complete where applicable.
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