HomeMy WebLinkAboutTERMITE TREATMENTEverglades Pest Management, Inc.
°Considering Your Environment'
State License Number 114708
11192 47th Road North Royal Palm Beach, FL 33411
561-333-8777 / FAX 561-333-8999 / Toll Free 866-414-PEST
Pre -Construction Subterranean Termite
Subdivision:
Address
City & Zip
Owner
Treatment L E" C (0 PY
Property Information
Lot Block: Section:
'LY 105- POSi-7 J - 04 f ie-rc.e
Name of Builder:
Shell Contractor:
Monolithic:
Addition:
Builder / Contractor Information
Construction Type
Floating/Stemwall: Patio: Entry: _ Driveway:_
Other: t�rfS
Product I Treatment Information
Treatment Date: Z-Ile / l Time: Te hnician: &
Treatment Type (must check one) Initial Under Slab: Supplem tal:
Product Applied: Cypermethdn: Premise 75 OtherA1P-10,-^
Concentration: _-VG % Mixed Product Applied: Gallons
Square Footage Treated: /-,7;, Linear Feet Treated:
If this is checked, then final perimeter treatment has been completed and the
following statement is applicable:
Certificate of Compliance: THIS BUILDING HAS RECEIVED A COMPLETE TREATMENT FOR THE
PREVENTION OF SUBTERRANEAN TERMITES. TREATMENT IS IN ACCORDANCE WITH THE RULES AND
LAWS ESTABLISHED BY THE FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES.
(Florida Building Code (FBC)1816.1.7)
Applicators Name (Please Print) 4-5e,4
SCANNED RECEIVED
BY
St. Lucie County APR 1 0 2017
5MT9&0(W ;)Ca 49t
Partial Treatment Notice
Sgbi11111S10N: n/a
Treated Area: minimum sq ft
PropertyAddreSS: 4905 SE Palm Drive Ft. Pierce
Lot/ Block/SeC.: n/a
Ordered By: Alpha Designs
TrealmeOt Date: 4/6/2017
Owner. n/a
Chemical: Bifenthrin (06%)
The above noted structure bas received the first of two or more required treatments for the prevention of
subterranean termites, per Florida Building Code 1816.
This form is for inspection or construction draw purposes only. The perimeter of the above structure must be treated
at final grade in accordance with pesticide label and Florida statute. Warranty and treatment certification will be
issued upon completion of final treatment.
This form should But be accepted as proof of complete IreatBlent for certificate of occupancy or
closing.
Notice to builder: Ills the rasoonsiblfty of the builder to notify&t*0 r,, should treatment he
reaulred for pages, driveways and entryways. Fern mast be notified at final grade of
smicliffe so final treatmenteao be co®pGiIBILWanantyWiled, and required paperwork for
closing submitted.
This is not proof of warranty. a n € �®' < m
License #114108 �,,�4-oD
For ?'Sorlafo.Ca11 561.333.6711ur666�414-PEST/tt19247Mflood Ranh naval palm fl&Il3gii��
J/s9erii4�`A'.
RECEIVED APR'-21 2017