1874 Tierra Verde Drive 2012 Pest Control FIELD DENSITY WORKSHEET
NUCLEAR DENSITY METHOD
(ASTIVI D 6938) 10 ,
JOB NO. CLIENT TECHNICIAN
JOBNAME DATE PERFORMED
GAUGE: MAKE MODEL SERIAL No. CALIBRATION DATE
REFERENCE STANDARD COUNTS: MOISTURE DENSITY Within Acceptable Range(s): Y N
TEST No.
TEST MODE(A or 8)
DEPTH (Rod)
TEST ELEVATION OR LIFT
OR DEPTH
MOISTURE COUNT
MOISTURE PCIF
MOISTURE PERCENT
DENSITY COUNT
WET DENSITY
DRY DENSITY
PROCTOR NUMBER
MAXIMUM DRY DENSITY
OPTIMUM MOISTURE
SPECIFIED COMPACTION
%COMPACTION
MATERIAL DESCRIPTIQ""
LOCATION
S ANNED
Test Meth xatter
F1014 2-2010 Reviewed By: Date:
H o m* elTle a m
PEST DEFE NSE6
Certificate of New Construction Subterranean Termite Treatment
This report is submitted for information purposes to the builder on(new)construction cases where treatment for prevention of
subterranean termite infestation is required by the Florida Building Code,Section 104.2.6
All contracts for service are between the pest control operator and bui1der unless otherwise stated.
Section 1: HomeTeam Pest Defense
Company Address: 3 C'0 poul Dr A, :
, — -State:--.. L
Zip: C Phone No.: Business License No.:
Section 2: Builder Information
Company Name: Company Phone No.:
Section 3: Property Information
Building Permit No.: —Location of structure(s)treated:..
Type of Construction: El Slab F� Basement El Crawl El Other:
Approximate depth of footing: Outside: Inside: -----Type Fill:
Section 4: Treatment Information
Date(s)of Treatment: EPA Registration No.:
Brand Name of Product(s)used:
Final mix solution: Treatment area sq. ft.:
Linear ft.: Linear ft.of masonry voids.
Total gallons of termiticide applied: Total number of termite bait stations installed:
Service agreement available? n Yes E] No This building has received a complete treatment
Liquid treatment: E] Yes E] No for the prevention of subterranean termites.
Treatment is in accordance with rules and laws
Liquid final exterior treatment: Yes [I No established by the Florida Department of
Borate treatment: E] Yes n No Agricultural and Consumer Services.
Bait in lieu of pretreat: C3 Yes El No Initial:
Note: State laws require service agreement to be issued. This form does not preempt State law.
Attachments(list):
Comments:
Name of applicator(s): Certification No.:
Authorized Signature: Date: Final:
9082-9/11