583 COASTAL OAK LN - TERMITE TREATMENT 1
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PEST DEFENSE JUN 2 3 2017
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New Construction Subterranean Termite Treatment L
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 services are between the Pest Control Operator and builder,unless stated otherwise.
Section 1: Hometeam Pest Defense
Company Address:6694 Columbia Park Drive City:Jacksonville State:FL
Zip: 32258 2409 Company Phone No.:904-730-2522 Business License No.: 1640370000
Section 2: Builder Information
Company Name:Southern Lifestyle Homes LLC
Phone No.:
Section 3: Property Information
Building Permit No.:
Location of Structure(s)Treated:583 Coastal Oaks Ln,Atlantic
Type of Construction: IA Slab ❑Basement ❑Crawl ❑Other
Approximate Depth of Footing: Outside: Inside: Type Fill:
Section 4:Treatment Information
Date(s)of Treatment(s):02/19/16 EPA Registration No.:64405-1-AA
Brand Name of Product(s)Used:Bora-Care
Final Mix Solution:23% Treatment Area Sq.Ft.:2900
Linear Ft. Linear Ft.of Masonry Voids:
Total Gallons of Termiticide Applied: 4
Service Agreement Available? ®Yes ❑No This building has received a complete treatment for the
Liquid treatment: 0 Yes ®No prevention of subterranean termites.Treatment is in
Liquid Final exterior treatment: ❑Yes ®No accordance with the rules and laws established by the
Borate treatment: ®Yes 0 No Florida Department of Agricultural and Consumer
Bait in lieu of Pretreat: 0 Yes ®No Services. Initial SL
Note:Some State laws require service agreements to be issued. This form does not preempt State law.
Attachments(List)
Comments
Name of Applicator(s):BLAKEHUEEYY �/ / n ��i Certification No.: JF198942
Authorized Signature c�(�/f�,ey/1//t�oC_�Y/C/l Date 02/19/16
RH•NT9/05