55 Donner - Final Termite Treatment Subterranean Termite Protection Builder's Guarantee OMB Approval No.2502-0525
This form is completed by the builder. (exio.GWO/2018)
Public reporting When for this collection of Inlormatoon Is refirmlecl to averace 5 minutes per resincnise,Including the Unne(or reviewing instructions,seard"
e4sling data scurrotoi,gaffiering and mambaring the data needed,and completing and reviewing the coliectinoth of information.Iribis information is required to
obtain lbarefift.HUD may not collect his information,and you am not required to complete this form,unless R di5plays a womanly,valid OMB control number.
Sectiori 24 crR 200.926d(b)(3)requires that the siters fict HUD insured structures must be hishe of hermite hatioacs,Tinis Information collection requires a
licensed Pest Control company to pawde the builder a record of specilic hisairrearl informatior,In those caves when 9 any method other Man Use of pressure
heated lumber is must for preventiorn of Subterranean byrnille Infestation.Witern applicable,form HUC-NPMA-9"must accompany the to.HIJD�NPMA-99-�
Builders,pest coadrol com"nies,mortgage lenders,homebuyerni,and HUD as a record of treatment for specific homes will use Me information(Xiflected.
The inforriftlion is not considemcl confidential,therefore no assurance of conficamiality is pralded!
'fris forrh 0 subrolled for contained(—)comyructioth ofters whan rhowention of suloorm.1.le ol.4itiort.specified by Me insider or required by the fthda,.the
ti�loc.FHAo-Vk
1rh,s I.Is 1.the compleftal by the binicer.rifts duasslaw Is ishothol by the Wider to the buyer.1rhft mranleeft not to W convothrid wahns or,or in Ito.of.My"to hois
or hinneyes Mat be low many Mwe Who Me buslar.
F�ACasi,hlo,:
luccasne of Strammis)fistret Address.a Leo Dsasaaboh,Day Staft am Z�) 55 Donner Rd
Atlantic Beach FIL 32233
BL"ra Name,
Malabar A to clack aric conackes Mesa M�I or W.Z
1 W�aa Control Cah,bay,,Appasil Thealmot(Sey H U"PW M bar vatitharrit in forrhason)
The UndOmilhArd Molder himbY cantles Met S Sam licansed Or OftnOW aUthordned met 001001 Mothosery berINNO restores by stale WW)was connected 10 Issinit Me
broNny V Me loodkoh reftnenced Nons,0 prinsint sastaftyroman hentes.The Water WW cerilies Met Me cortmol win Me cost innhol connowny shinned Me
Warrant Materials and onnMods nmr!to W in conlohnneenche�all anioricable Slale and Federml�.b.M wo,b Minas by in.conaract beft bernh .,IeIW
�ness nacd.HUD-bilokl[k We,who.non crohibled by ppecafte Sufte rexinarents.me tartar for an asoachim ass ,W In the wt conarty;conrionan, y
extend Me,prottyAlon al,airs!subtermhaan tinnytes,Cormad Me neryl control connonrr board M the OffachahoM lot,further h1conefibn
The buider hereby varstrimits thal,rf�bfthaftan terns,MInstifion sho.lal�r withirt one year borb the dale of clonso,,the bracer will anstra that a boafted or
overnse state uthcrimol cast control chrovithy will bear Me hemboar,to conam infesitilions h Me"um.Thh tirther newshern"be mhoo onat M Me ww
It Menrideci by Staft!&�.tre thwer haw contord Or",a(Me lotryin's expearria,with a coast conthol cornhany to insprot ther property on a beirroofic basis and i,se
EPA rogisubbel peckels to convol"inkistalicin.TIM,WWw we hot he hingoinsible for guaranhhon,s�contraded�.TIM,Witter further areeS to repair an
Mona,e by subterranean harrit.yrthin Oft ona,ear WiMr.wishoM,perce.riles hasnox,oce..1 apply to aciften.or emotions;that..mose by the buyer,
M,,ch affixas Me.6,inal "ckae or Mommarl.Enamples,lockde,tal.not lionsell M, and!nnAct Aerations.which dinabab Me Minflad a.and chains
new stabienoine.h hornite havards,or Internet with be ocintol ..if within the gwisanhin,Maind Me Ishildir Mention.Me walitfity a.days by Me buyer,Ons
danin"I W inmtignaid by an urafteed!exnn,rourbially nameable to the bti,er and!Indider.The stood!of the M,owl WIN be accepted ft;My bass lor distention 0
the...The pary,wil oa,Me.9 of arvy Mady,W Inteshilaft[be claft.For further on.ftol yotitr State slooleal Pest contral
re,ust acene,y A 11 Mention must W Ith complia. Mh ffba�lishorriftlonal Reston Wal Cade.
,TyWo1SM,*ay: ED Termer sat sysifte Fy4hedApplial Vwnd Treavirsent El�IT.�l (=Irwallehl Physical Sayner system
2.(51hulder,Insibilliall StAlsons.'fiandia Isravablion uMat,lonessions,Treadell 1-ftobal
That Mother carbries,Met washreanean borne ewnhion was installed usn,�ro treated�hnfthr only am confies thim use of the yesstan thronad lurrater a in
conplanct,win iiolichable bwksh,codes ard!HUD munharrionst,Imthtdr,k,on,,a,ea LeMer 20014M�Note;Using pressurs therned"Is Me a wle mitinnif a
lemall. mintrifion Is NOT c.,lable nd�Ioftlkft the nytholmovirds of Minit,ni,es LeM.I 20014M.
Cate
AfischonerW
No.
Muldent pass;_L211412018
Consumer fifthranams;AdAtione,ragiMan,Magnetite Past manewhatera for Prewarmon a%food Dentiontim Insects.Inforearkin negainfing orrhantion of yeadi destanial;
firsojeficin at aftenwbbol cont routy hade,firewood! ,alml stroorms, hanifficebtl wstAblion,hoostim.wood defors irt coml since.wootl youlch.Ime beenchas
machine anuchoses,Whobsoaft,fihnb�.�and wooll roi.should Mentip or near,soch conditions et�lsl.canyons,.should be halt.by Far onner in aft,to hadea Me
coatchis of infirstaborat by wooto Mosynying Matters.ind!Me need for trinithert
M origaial arrof ona bay,of Mis Marantee are In be pmothera by for W loser and!sent to Me len:lfty�'The lenclan,prowdes,one copy to Met buter at cleeng Ond hire�3 copy in Me
�loarn packate or HUD lrs�mhc*case trocli,Iffin,toulder stands che occry to the lionessell Pest thirrhol ohrWy�ict,Wonnod the insionart.
Attached N a as,of Me stale,authichood cost comol company',New�1,udnn solve.Tomes Sennoo Reoonc.HUD-~-W-13.
Warning,HUD W proahAff rose dwors and cornnchon May,most,In onnimil anotor core!cannabis j 18 U&C,1001,1010,1012:31 U.S.C.XFW3802)
I
New Construction Subterranean Termite OMB AppmvW No.2502-0525
Service Record (exa.OSM2016)
is by the I]-=rPs'l.Z to CF SK
farUiial_ 1,
e-rille 12-111-serali.15 Minutes Par response,Including the Ume for neviewmil;Instructions,
searching existing data sources,gathering and maintaining"data needed,and complating anct reviewing One collection of Information.This inkarnatic.
its rMpimd to oblairi benefits.HUD may hot collect this infornsisficorr.and you are not required to compete this form unless it dispins;a currently vast OMB
c:onticl numbes.
Section 24 CFR 200.926d(lb)(3)requir"met tha Mes for HUD insured structures,nn�st be free of Itsmile linards.This Inkenation colkiction natiulnes the
Wilder to certify that an authorized Pest Conlml corrmany perforated all required theatimern for termites,and that the busider guarantees the treated area
against Infestation for one yew.guilders,past conuvil companies,hicrtgage lenders, hannebuyers.and HUD as a repand!of trestriert W specific homes will
use the Information collected.The infornmilion is not consideneol confidential,therefore,no assurance of canfidentiality'is pri,itfided.
This report is submitted kor Informational purposes[a One builder an proposed(new)construction cases~Weaftment for pre�tixxh of subternmean termi�
infestation is specified by the Wider,exchited,o,required!by Ime tender,arctutect.FHA,or VA,
All contracts for serVIOGS am baffitsesh the PW CWW cOrnislify and Wide,,unless stateal otherise
Section 1:General Information(Pest Control Company Inklmnation)
Company Name: Turner Pest Control
C1yAddmxa 8400 Baymeadows Way, Suite 12 yJacksonville Florida Z,, 32256
CompanylluunnessUcami JS 112358 CompanylobareNo 904-355-5300
FHAIVA Case No.(if any)
Sm,don 2:Build.Information
Company Name Christopher Homes PhOMS No. 904-241-5251
Secillon 3:Pralierly Information
Location of Strutchure(a)Treated(Slimat Address or Legal Description.Cfty�Slate and Zp)55 Donner Rd Atlantic Beach FL 32233
Sactilm 4:Sm,vice Information,
Dale(s)of Senfit;Ms) 11115/17 02/13/18
Type of Comitruclion(More than one box may be checked) Dab E] Basiament E]CmxA � Wood Frame
Clmck all that apply:
A.Soll Applied Uffuid Termifickle
Brand Name d TsmuffolosPrrhiss Pro EPA Registration No.432-1449
Approx.Diludal,J%):05 Apprus.Total Gallons Mix Apptied:60 Treatmeot compatied an exterior[]Y. No
FV 8 Wood Applied Liquid Tiermidelde
Brand Nam of Tarmitick]. M--- EPA RejetcationNo. (1,1405-1
Appmx.DJfUVm(%): 23 Approx.Total Gallons MixApplied: 2
C�aml system Installed
Name 04 Syxtaxm�EPA Regishaficn No._ Number of Stations Insisted
D.Physical Banner Systern Installed
Name of System Attach installation Information hosquilmol
ServiceAgreeminsitAvailade yes No
Note:Some state laws mquirzIce agreements to be anuec.This form does W preempt state taw.
Aftach.ents(LIM)
Coninne"u;
Narnea(Applicalon(s) Shawn Svehla Shawn Svehla Ceftilical No.(if required by State law) JE95283 JE95283
The applicator has used a product In accordance with the pnoducl latial and state All materials and methoch;used comply with State and federal
naguations. 00�'�
A.Ahorzed Signaftere owe 02/14/2018
Ithemdril HUD wit poxcula base omins are,iditkxnah�rxay ressift in cinunal andss,mill Pirialline.(18 U.&C 1001.1010 1012:31 U.&C,3729.W2)
fismi HUC,N�
=Turner
.MPest
EMControl
TERMITE CERTIFICATE
INFORMATION REQUIRED AS PER FLORIDA BUILDING CODES 104.2.6 & 1816.1
CONTRACTOR: Christopher Homes
355 1 1th St
Atlantic Beach FIL 32233
SITE LOCATION: Christopher Homes
55 Donner Rd
Atlantic Beach FL 32233
PERMIT#: 17-73401
DATE OF TREATMENT: 11115/17 02/13/18
AREATREATED: 183 Linear 636 Linear
IDENTITY OF APPLICATOR: Shawn Svehla JE95283 Shawn Svehla JE95283
PRODucr NAME: Premise PrD Bora-wre
CHEMICAL NAME: Imidacloprid Disodiurn Octaborate Tetrahydrate
(DIFFERENTIFROMPRODUCF)
(FOR MIT SYSTEMS-UST CHEMICAL NAME THAT WILL MUSED IF TERMITE AM DETECTED)
PRECENT CONCENTRATION: .05 23
(FOR MIT SYSTEMS-IF YOU DCW'T HAVE WE�71U.HOW MANY STATIONS PER FO90
NUMBER OF GALLONS: 60 Gallons 2 Gallons
(FOR BAIT STATIONS-ENTER It OF STATIONS USED)
FINALSTATEMENT,
THE BUILDING HAS RECENED A COMPLETE TREATMENT FOR THE PRINENTION OF SUBTERRANEAN TERMITES.TREATMENT IS IN ACDORDANCE
WITH THE RULES AND LAWS ESTABLISHED W THE STATE OF FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES. IAGREE
THAT ME ABOVE INFORMATION 6 CORRECT AND REFERS TO THE ADDRESS LISTED ABCAK
x
URNER PEST CONTROL U.0
MOD GAYMENOOWS WAY,SUITE 12
JACKSONVILLE,IT 32256 EINI-355-S300
GENERAL TERMS AND CONDITIONS
Them allandandern emaddefor T.1—I.N.Centel daymen an Into,hanne...may, ammadmant..—. a..knommor,a,
T—I.N cand.h...lodatla.m. mam"aaam. It.a makel—bard madama.deal
'ne,my.. .W,
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made..1m..N— ..d-family am,.1.1.—ad-thard,mandeadd,.mundahman dommartakir of 1..1
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to....,...ad me a ammund
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"ampereadmommanemay."domp'..eyeaffin,
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beat
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be deal dratme...maymodial..d.andum amplackmay,Tommy Pail..nl.l do.. ammandame at an,coname,..heyean monamseark,
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