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Port St. Lucie Building L 6p&ment THIS FORM is TO BE FILLED OUT
BY PEST CONTROL COMPANY
Certificate of Compliance
[This is a partial treatment only and not a guarantee or warranty)
PERMIT NUMBER: 1 5o b — 0 C) a-(,a
LOCATION OF PROPERTY: Agize- AJ i
LEGAL DESCRIPTION: SECTION:. &Q6-9, ?Aai r BLOCK LOT:
00 PEST CONTROL COMPANY TREATMENT INFORMATION
to /0's- /is—
DATE OF TREATMEN7
'COM?7WNER-PLEASE NT
T
4-a CHEMICAL USED
— SIGN-AW ou
E
CONCENTRATION
DATE TITLE
GALLONS USED
SOIL TREATMENT COMPANY IN METHOD OF APPLICATION[r�odded,Soil Mixed,ETC.)
55
SOIL TREATMENT COMPANY NAME LINEAR FOOTAGE OF AREA TREATED
(D
E SECOND TREATMENT INFORMATION
ADDRESS
DATE OF TREATMENT
SOIL TREATMENT/DACS LICENSE#
CHEMICAL USED
0 The building has received a complete treatment for the
CO Prevention of subterranean termites, Treatment is in CONCENTRATION
Accordance with the rules and laws established by the
Florida Department of Agriculture and Consumer Services. GALLONS USED
'A second treatment was done on [DateL--L / as per
Manufacturer's specification. If the second treatment is not METHOD OF APPLICAnON[Rodded,soil mixed,ETC.]
required, a copy of the product label shall be included with
This Certificate.
0 LINEAR FOOTAGE OF AREA TREATED
0
Please Note: The City of Port St.Lucie does not guarantee or warranty the preconstruction soil treatment attested to
in the above. The purpose of this document is to show that to the best of this Departments knowledge, the builder
has satisfied the requirements of the Florida Building Code for protection against termites.
This form must be returned to the Building Department
before your final inspection is scheduled.