HomeMy WebLinkAboutInspection Docs � Y y
® the Tri Co,
INC. �^
588 NW Mercantile Place Port St. Lucie, FL 34986
Office 772-879-0904 Fax 772-879-1116 Emai]:Service@ Coastal PestCciZ'?ro!FL.ccm
Certificate ®f `fermate Treatmentj S®oll `treatment
Permit# I bO —03" Job Street Address -203 ��Z/ �&irl'iiii (�
Job City,State,Zip
BuilderC � Legal Description:Section Block Lot
Soil Treatment Company Information
Coastal Pest Control of the Treasure Coast Inc.
588 WW Mercantile Place Port St.Lucie, FL 34986
D.A.C.S. License#JB5594/Cerrtif tate#8068
Treatment Information Second Treatment/Final
4
Treatment Date/Time ® Treatment Date/Time
4,9 Chemical Used Chemical Used
ofo Concentration Concentration
Gallons Used Gallons Used
&OAP C.4SI Application Method Application Method
ply ' i inear/Scyuare Footage / Linear/Square Footage
APP T IGNATURE
FBC104.2.6 Certificate of Protective Treatment for Prevention of Termites
A weather resistance jobsite posting board shall be provided to receive duplicate treatment certificates as each required protective
treatment is completed,providing a copy for each person the permit is issued to and another copy for the building permit files.The
treatment certificate shall provide product used identity.of the applicator,time and date of the treatment,site location,area treated,
chemicals used,percent concentration,and number of gallons used,to establish a verifiable record of protective treatment.If the soil
chemical barrier method for termite prevention is used,final exterior treatments shall be completed prior to final building approval.
tAL "The On Time Conc'ete,Company"CENTRAL CONCRETE SUPERMIX, INC.CONCRETE DISPATCHERS:South Dispatch: (305)264-7101 North Dispatch: (561)826-9364 CUSTOMER NO. DELIVERY TICKET . D&E
Block Dispatch: (305)806-3226
WWW.SUPERMIX.COM i.+I•dt_;t�!.�dt i• 9 f.;-' =1}'.;''c', 4s a; .-r;, i (.
-- MAIN OFFICE: 4300 S.W:,74,th Ave. • Miami, FL 33155
PHONE:_(305) 262-3250 -,FAX: (305) 267;0698 -
SERVING;MIAMI-DADE,, BROWARD, PALM BEACH, MARTIN & ST. LUCIE COUNTIES
SOLD,TO DELIVERY ADDRESS
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al: ,. c-t. . I,.Er'rK)i-1!'dlfY
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QUANTITY ITEM DESCRIPTION UNIT PRICE EXTENSION
y ,r0 ;t'J"t'J s -i1:.'t!C'1('i ls;F•_(`i l(_(J{K! !F;%f U 1-•i=1 i.: ['.4�
�. !;'31it 1-• I:1:i..i�,.t=t l . t��:r�}{I.'t".f•s8=t-iE-d _ !I I..c:i ;!T„'�' 1.4�
MINUTES — ALLOWABLE TIME' — PER MINUTE —
EXTRA UNLOADING TIME CHARGE X$1.00
"6 MINUTES PER CU. YD. ALLOWED SHORT LOAD CHARGE y
SLUMP
THIS DELIVERY TOTAL CU. YDS. AMOUNT
OF YOUR ORDER FOR CU. YDS. TAX
CUSTOMER OR HIS AGENT ASSUMES FULL RESPONSIBILITY FOR STRENGTH AND/OR
PERFORMANCE OF ANY CONCRETE PLACED ABOVE DESIGN SLUMP OR WHEN • °
WATER IS ADDED. WATER ADDED Z) YES1:1NO GLS. 1 I+ A) �� iL{
TIME ARRIVED ON JOB, STARTED UNLOADING FINISHED UNLOADING LEAVING THIS JOB TOTALTIME
l
SUBJECT TO THE TERMS, CONDITIONS AND 'CAUTION"WARNING LISTED ON BOTH THE
FRONT AND BACK OF THIS TICKET.
TRUCK DRIVER I acknowledge that I have received and accepted the materials listed on this ticket. I
�.:.t'f r I- ,,t,i; ;.s1�•s,:{; understand and agree to the terms on both the front and back of this ticket.
RECEIVED BY: X
CONTROL 21 LOADING POINTS AT 16 LOCATIONS TO SERVE YOU BETTER
o��ox� MIAMI-DOWNTOWN MIAMI•WEST MIAMI-AIRPORT-OPA-LOCKA-MEDLEY-PERRINE-PEMBROKE PINES VC(
�F �' DEERFIELD•BOCA RATON-RIVIERA BEACH•STUART-W.BROWARD-FT.PIERCE•E.BROWARD•DELRAY ll��
PRODUCERS AND SUPPLIERS OF QUALITY READY MIXED CONCREIE AND CONCRETE BLOCK NRMCA
°S DELIVERY COPY
CAUTION!s FRESHLY MIXED CEMENT, MORTAR, CONCRETE OR
GROUT MAY CAUSE SKIN INJURY AVOID CONTACT WITH EYES WHERE
POSSIBLE AND AASH EXPOSED SKIN AREAS PROMPTLY WITH WATER.
IF ANY CEMENT MIXTURES GET INTO EYES, RINSE IMMEDIATELY AND
REPEATEDLY WITH WATER AND GET PROMPT MEDICAL TREATMENT
SAWING, OR GRINDING OF CON RETE MASONRY UNITS MAY RESULT
IN THE RELEASE OF DUST PARTICLES WHICH, WITHOUT THE USE OF
PROPER EYE OR RESPIRATORY PROTECTION, COULD CAUSE EYE OR
NOSE IRRITATION. THE MATERIAL SAFETY DATA SHEETS FOR TIME
PRODUCTS SOLD BY CENTRAL CONCRETE SUPERMIX, INC. ARE
AVAILABLE UPON REQUEST
UNLOADINGDRIVERS ARE PROHIBITED FROM DELIVERING
r CONCRETE EXCEPT UNDER THE TRUCK'S OWN POWER, AND WHERE
SITE CONDITIONS PERMIT THE SAFE AND PROPER OPERATION OF HIS
EQUIPMENT. DRIVERS ARE NOT PERMITTED TO ADD NATER TO THE
MIX NOR TO GO BEYOND THE CURB LINE, EXCEPT UPON THE
AUTHORIZATION OF THE PURCHASER/PURCHASER'S AGENT AND HIS
.ACCEPTANCE OF RISK FOR ANY LOSS OR DAMAGE.
BUYER, OR HIS AGENT, AGREES TO ASSUME RESPONSIBILITY FOR
CONCRETE, .AND ANY PROPERTY DAMAGE RESULTING FROM TRUCK
MAKING DELIVERY BEYOND CURB LINE. ALL CLAIMS MUST BE MADE
AT TIME OF DELIVERY.
IF IT BECOMES .NECESSARY TO BRING ,ANY ACTION TO COLLECT
AMOUNTS DUE ON THIS INVOICE, PURCHASER SHALL BE RESPONSIBLE
FOR REASONABLE ATT ORNEYS FEES AND COURT COSTS INCURRED_
BY VENDOR IN SECURING COLLECTIONS. INTEREST SHAD.ACCRUE
AT 1 1 /2% PER MONTH ON OUTSTANDING BALANCES.