HomeMy WebLinkAboutTERMITE TREATMENT CERTIFICATEJan 1420,12:54p p.2
RECEIVE"`
C �"
]AN 141u1a ` _()
Q (�j 7 3) rmRt�u9 D Cou Nept
1 "" '_G�j Ghristia:�i 772-323-7921
• Termite Inspection esUs col
• Termite Pretreatment fuict-A-Bug a loll free:1-811.365.9990
• Pest Control Termite & fax: 712-349.5906
• Rodent Service Pest , Email: Evictabug@gmail.com
• Fire Ant Lawn Service Control,
• Whitefly Treatment Inc. 4293 SW High Meadows Ave.
Lic. JB175775
4censed-&Insured— _ _ Palm City, FL 34990
r IR Notice of Preventative Treatment for Termites
�c7 (as required by Florida Building Code (FBC)104.2.6, 105.10 & R318.1 and Broward County Chapter FBC 105.2.2)
PEST PREVENTION I FIREANTSERVICE I TERMITESERVICE I RODENT EXCLUSION& REMOVAL 1 WHITEFLY TREATMENT
DATE OF SERVICE i- I q ' � 6 TIME IC),' dL4
CONTACT PERSON
b
❑ FLOATING MONOLITHIC
O PATIO O GARAGE
❑ DRIVEWAY ❑ STEM WALLIFOOTERS ❑ ADDITION
❑ CUTOUTS ❑ FOOTER
0 FRONT ENTRY ❑ RETREAT
❑ BORACARE TREATMENT ❑ PLUMBING CUTOUTS ❑ SIDEWALKS
❑TAMP&TREAT VdJREATOM.Y
❑FINAL 0POOL DECK
OTHER
66MM
PRODUCTS
�rr�-�,�/�
B
LJ BA5ELINE rti[DOMINION 2LACTIVE
VV ��
INGREDIENT ❑ TERMIDOR SC O BORACARE O PREMISE O TALSTAR "
St. 0 ij6pN' ►iPitv
❑ OTHER
'ACTIVE INGREDIENT
ADACLAPRiD OBIFENTHRIN ❑DISODIUMOCTABORATETETRAHYDRATE
CONCENTRATION
0.06% 0.1% 0.12%/0.25%
`i 85% 1323% ❑9% ❑OTHER
GALLONSAPPUED !� ej
SQUARE FOOTAGE
LINEARFOOTAGE
SQUARE FOOTAGE VERIFIED
❑NO
MEASURED OR VERIFIED PER PLANS
PY€S v NO
"Certificate of Compliance"
As per 104.2.6,105.10 & R318.1 FBC • If soil chemical barrier method for termite prevention is used. '
Final exterior treatment shall be completed prior to final building approval.
Certificate of Compliance: The building has received a complete treatment for the prevention of subterranean termites. Treatment 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 1
FINAL STICKER
❑ ELECTRICAL PANEL El WATER HEATER
Payment Torma, Payment due at time of service.
5 t.l i
Date II
Date
Customer (Property
and Mt Control. Inc.)
www.eviclabugpesicontrol.com
Jan 1420, 12:54p
p.1
PEP,MIT #: j CjCq—CCS/ JOB ADC
BUILDER/CONTRACTOR:
P
EJ I CONTROL CONTRACTOR: EVICT -A -BUG TERMITE & PEST CONTROL INC.
PEST CONTROL LICENSE #: JB175775
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: °1•-53-0 Chemicals used: DOMINION 2L
Percentage of solution:_•05% _
Date of Treatment: I �.9iiW
tfng
It
Treatment
Re -Treat
Driveway
1't Treatment
TRe T at
D� Other
1' Treatmehf
Re -Treat
Note: There must be a completed form for each
site to be pled up by the inspector at Ume of e
fee charged.
Total gallons used:
Time of Treatment:
S
lab
1� Treatment
Re -Treat
Pools
1� Treatment
Final
Date
ment orrejfeatmentand this form must be on the job
or the sc eduled Inspection will fall and a re -Inspection
FBC104.2.6CertificateofprotectiveTreatment forprevenbonoftermites Aweatherreslstantjobsitepostingboard
shall be provided to receive duplicate Treatment Cert/flcates as each required protective treatment is completed,
prov/ding a copy for the person the permit15 issued to and another copy for the bullding permit Ales The Treatment
Certificate shall provide the product used, identity of the applicator, ttme and date of the treatment, site location, area
treated, chemical used, percent concentration and number of gallons used, to establish a vedfiable record of
protective treatment. If the soil chemical barrier method for termite prevention Is used, final exterior treatmentshall
be completed prior to final bullding approval.
St Lucie County requires for the final Inspection for CO, a Permanent Sticker to be placed an
the electrical panel box cover, listing all the treatments and dates of applications.
7/24/2614