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PROTECTION AGAINST TERM- IITES
PERMIT NO. / °'A ®OV ADDRESS: qJ502- �CSn =�� �-�✓
BUILDER: Pakrkp.7f -
The above referenced address meets or exceeds the requirements for protection
against termites set forth in the 2006 International Residential Code and the treatment
was done in compliance with the Regulations of the Structural Pest Control Board of
Texas and the EPA Registered Manufacturer's Directions for the Use of Pesticides.
Name of Protection Provider (Company):
Address:
Phone No.: (� 1-7 _ d ` CzN
State License No.: e e, 1- 13 Y 4
STATE OF TEXAS
COUNTY OF �C
1, < ff
,being duly sworn both deposed and say that
the information contained in above application is true and correct to the best of my
know edge d belief.
Signat e
4-.,g, o - 115-
Date
Subscribed and sworn to before me thiscWday of 6?K c _, 20
r ry
i/ • �a:. PAIGE KIRKMAN
otary Public in and forthe S tate of Texas 'Z�.e: Notary Public, State of Texas
My Commission Expires
January 30, 2018
OAFORMSOS CONTRACTOR FORMS \TERMITE PROTECTION.doc
0907
P.O. Box 820753
North Richland Hills, TX 76182
817 -812 -BUZZ (2899)
214- 295 -8789
TPCL #13842
Date of service: 20 Invoice #
Arrival: Departure: Technician and #:
Customer Name: Phone:
Service to Address:
City: Zip:
Type of Service: Target Pest:
*ALL LABOR AND MATERIALS USED ARE IN ACCORDANCE TO LABEL DIRECTIONS*
MATERIALS USED
%
AMOUNT
MATERIALS USED
%
AMOUNT
MATERIALS USED
%
AMOUNT
EPA EEG. No.
EPA EEG. No.
EPA EEG. No.
1) Advance G. Ant Bait
.011
10) Glueboards
19) Riptide
.046
No. 499 -370
(see notes /graph for location)
No. 1021 -1785
2) Maxforce FC Select
.01
11) Intice G. Bait
5.0
20) Termidor SC
.06
No. 432 -1259
No. 73079 -2
No. 7969 -210
3) 221L
.05
12) Onslaught FASTCAP
.025
21) Talstar P
.03
No. 499 -473
No. 1021 -1815
No. 279 -3206
4) Bedlam
.4
13) Optigard Ant Gel
.010
22) First Strike Bait
.0025
No. 1021 -1767
No. 100 -1260
No. 7173 -258
5) Top Choice
.0143
14) Permethrin G. HJ
.25
23) Termidor HE
.06
No. 432 -1217
No. 53883 -39 -32802
No. 7969 -329
6) Contrac Blox
.005
15) Phantom
.25
24) Harmonix
.03
No. 12455 -79
No. 241 -392
No. 432 -1526
7) Delta Dust
.05
16) Phantom Aerosol
.5
25) Sector
.09
No. 432 -772
No. 7969 -285
No. 1013 -1113
8) Demand CS
.03
17) Precor IGR
.007
26)
No. 100 -1066
No. 2724 -352
9) Gentrol IGR
.8
18) Premise Foam
.05
27)
No. 2724-351
No. 432-1391
Scope of Service: Wind Direction Wind Speed
# Treated interior baseboards, door jams, and exterlor porch areas
# Treated exterior: perimeter,/ front yard / back yard,/ spot eaves fire ant mounds in yard.
# Treated attic / crawl space / bait box
# Location of Devices per Graph and / or notes
Performed cobweb elimination to: exterior lights / porches / eaves
ElOutside Only Service Performed: We feel that the exterior treatment of the home is of primary importance in eliminating pests
from your living environment. The interior of your home is under guarantee should any problem arise. Your statement will show
this service as a full price service.
Guarantee: 30 day 45 day 60 day 90 day 180 day l yr.
2nd Application is required: Y / N day guarantee will come after 2nd application
Next scheduled service: 20
Additional Information:
�uuLU�a><
Payment Method: Tax
By Customer: Total
(Authorized signature)
* Payment is due within 15 days of service rendered*
Interested in pest tips, updates or seasonal promotions join our Email list:
Thanks, we appreciate your business!
Licensed and regulated under the Texas Structural Pest Control Act
10 -14 P.O. Box 12847 -Austin, Texas 78711 -2847 - (512) 305 -8250
PEST CONTROL
We put the SQUEEZI on bugs!
P.O. Box 820753
North Richland Hills, TX 76182
817 - 812 -BUZZ (2899)
www.buzzkillpestcontrol.com
TPCL #13842
TERMITE TREATMENT DISCLOSURE DOCUMENT
Technician and # Date: 20
Customer Name: Phone:
Address: City: Zip Code:
Location to be Treated:
A Label of / r Y r 1: t , /> y' �--. has been enclosed with this document.
Diagram of Structure
E - Evidence
A -
(Active) Infestation
P -
(Previous) Infestation
S -
Subterranean Termite
F -
Formosan Termite
C -
Conducive Conditions
X -
Area(s) to be drilled
0-
Area(s) to be trenched
R -
Area(s) to be rodded
B -
Area(s) to be baited
Treatment Type
Partial
❑ Spot
❑ Bait / # of stations to be installed
❑ Other
❑ Physical Barrier
Type of Construction
❑ Pier and Beam
Obstructed or Inaccessible Areas:
Approximate measurements of the structure(s) to be treated:
The percentage of Termiticide to be applied at this location is: r % Estimated gallons:
Conditions that could develop which would void this warranty:
Definitions of treatments
A subterranean termite treatment may be either a partial treatment or a spot treatment, involving the use of chemicals or physical barriers, or the treatment
may include the use of a baiting system. These types of treatments are defined as follows:
Partial Treatment
This technique allows a wide variety of treatment strategies but is more involved than a spot treatment. (See definition below.)
Example: treatment of some or all of the perimeter, bath traps, expansion joints, stress cracks, portions of framing and walls.
> Pier and Beam:
Generally defined as the treatment of the outer perimeter including porches, patios and treatment of the attached garages. In the crawl space, treatment would
include and soil to structure contacts as well as removal of any wood debris on the ground.
> Slab Construction:
Generally defined as treatment of the perimeter and all known slab penetrations as well as any known expansion joints or stress cracks.
Spot Treatment
Any treatment which concerns a limited, defined area less than ten (10) linear or square feet that is intended to protect a specific location or "spot." Often
there are adjacent areas susceptible to termite infestation which are not treated.
Baiting System
This type of treatment may include interior and /or perimeter placement of monitoring or baiting stations along with routine inspection intervals. The baiting
technique may include one or more baiting locations as prescribed by the product label and instructions.
Buzz Kill Pest Control, LLC is responsible for providing labor and materials for the treatment of subterranean termite control for the structure at the above
address in accordance with the label directions and noted diagram. Included with this treatment is a warranty against termite infestation or reinfestation for
one year. This warranty does not cover against any previous or future damage caused by subterranean termites to the above address. This warranty can be
renewed annually for the number or years and fee stated below. This fee must be paid prior to the anniversary date each year. If the annual payment is not
received before the expiration date, Buzz Kill Pest Control, LLC will cancel the warranty and be relieved of any further obligation.
Option 1) Treatment cost: $ Product used Renewal cost: $ # years
Option 2) Treatment cost: $ Product used
Renewal cost: S. # years
(Customer signature / Property Owner) (Date) (Signature of Certified Applicator / Technician completing Est.)