HomeMy WebLinkAboutTERMITE TREATMENT CERTIFICATETERMITE PRETREAT SPECIALIAI�LC — [� 12
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VICAN99 6 License JB228623
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Notice of Preventative Treatment for Termies/'� t
(as required by Florida Building Code (FBC) 2326.5 and Broward County Chapter FBC 105.2.2)
CONCRETE WASHOUT SERVICES I TERMITE PROTECTION I PEST CONTROL I MOSQUITO CONTROL RODENT CONTROL
SERVICE ORDER NUMBER Iry 14 20 1 SERVICE DATE 3 I q Ilo 1 f j TIME )d r IO E M WEATHER CONDITIONS CLEAR
DEVELOPMENT NAME (PROJECT) CONTRACTOR'S NAME CONTACT PERSON
F F co t f— Ph0F Al iX I CLH
STRUCTURE ADDRESS (LOT/BLOCK) CITY, STATE, ZIP CODE COUNT
11 I a VEEA/ 60)/I/F R L- r-T 120131 PiERCE PL3 qGH S`LUCIE
CONTACT PHONE NUMBER NOTES
:Z o 3R `A1L TER i E -T tlgT EN D-j?oaga F7
TREATMENT TYPE/AREA
❑ FLOATING ❑ MONOLITHIC
❑ CUTOUTS ❑ FOOTERS
TREATMENT TYPE
❑ TAMP &TREAT ❑TREAT ONLY
PRODUCT
❑ DOMINION /ADONIS 2F
ACTIVE INGREDIENT I M ) P
❑ PATIO ❑ GARAGE ❑ DRIVEWAY ❑ STEM WALL ❑ ADDITION
❑ FRONT ENTRY EXTERIOR PERIMETER FOR RENEWAL ❑ OTHER
FINAL LIRETREAT ❑ BORA CARE TREATMENT ❑ TERMITE BAIT STATION
❑ PREMISE , ❑ DEMON TC ❑ TERMIDOR ❑ BORACARE ❑ OTHER
CONCENTRATION
❑ .05% ❑ .06% W11}% ❑ .12% ❑ .25% ❑ OTHER — GALLONS APPLIED a
SQUARE FOOTAGE 7 O 6 LINEAR FOOTAGE
S ARE FOOTAGE VERIFIED
YES ❑ NO ❑ MEASURED OR VERIFIED PER PLANS
JOB READY CONDITIONS MET
VES ❑ NO DETAILS
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SAFETY CONDITIONS () 6 O U
As per 2326.5 FBC - If soil chemical barrier method for termite prevention is used. Final exterior treatment shall be completed prior f f aor� al.
Certificate of Compliance: The building has received a complete treatment for the prevention of subterranean termites 7AUrient is in accordance with rules and
laws established by the Florida Department of Agriculture and Consumer Services. (Per the Florida Building Code.)
If this notice is for the final exterior treatment, initial and date this line 03 log I is {TERMITE MONIT P RI ONE D
FINAL STICKER
❑ ELECTRICAL PANEL ❑ WATER HEATER OTHER rl
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Payment Terms: Customer's payment in full is due at time of initial service. Customer agrees that a finance cl argL* in'the amount of 18 % per annum will
be assessed an all unpaid balances that are not satisfied by the due date. In the event a collection process becomes necessary to recover an unpaid
balance the following fees will be assessed including but not limited to: collection service fee, attorney's fee, finance charges and non -sufficient funds
(payment fe Customer will be responsible for paying costs associated with any collection process.
I 6 FU cc
Date Applicator (Diligent Services)
Date Customer (Property Owner or Agent)
Corporate 3500 NW Boca Raton Blvd. I Suite 714 I Boca Raton, Florida 33431 1 1-800-DILIGENT