Fillable NCDA&CS TERMITE Pest Control Company Information RECORD NEW (Information Technology Services)

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NCDA&CS TERMITE Pest Control Company Information RECORD NEW (Information Technology Services)

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NCDA&CS
STRUCTURAL PEST
CONTROL AND
PESTICIDES DIVISION
1090 MSC
Raleigh, NC 27699-1090
Ph. 919 733-6100
Fax 919 733-0633
NEW
CONSTRUCTION
TERMITE
TREATMENT
RECORD
Pest Control Company Information
Licensee Lic. No.
Company Name
Address:
Phone No. Fax No.
Property Description / Address
Lot or Street No.
Additional Description
Soil Treatment Completion Record
Treatment site Date
*
Product % Amount
Footing trench
Adjacent to
foundation walls
– interior
Other:
Soil beneath slabs:
Main floor slab
Garage / carport
Storage room
Earth-filled slabs
Other:
Exterior completion:
Adjacent to
exterior
foundation walls
Beneath
walkways / patios
etc.
Other:
Baiting System Installation
Treatment site Date Product %
# of
Stations
Wood Treatment
Treatment site Date Product % Amount
Floor system
Walls
Other:
*
Indicates the date of treatment of that element of construction.
NCDA&CS
STRUCTURAL PEST
CONTROL AND
PESTICIDES DIVISION
1090 MSC
Raleigh, NC 27699-1090
Ph. 919 733-6100
Fax 919 733-0633
NEW
CONSTRUCTION
TERMITE
TREATMENT
RECORD
Pest Control Company Information
Licensee Lic. No.
Company Name
Address:
Phone No. Fax No.
Property Description / Address
Lot or Street No.
Additional Description
Soil Treatment Completion Record
Treatment site Date
*
Product % Amount
Footing trench
Adjacent to
foundation walls
– interior
Other:
Soil beneath slabs:
Main floor slab
Garage / carport
Storage room
Earth-filled slabs
Other:
Exterior completion:
Adjacent to
exterior
foundation walls
Beneath
walkways / patios
etc.
Other:
Baiting System Installation
Treatment site Date Product %
# of
Stations
Wood Treatment
Treatment site Date Product % Amount
Floor system
Walls
Other:
*
Indicates the date of treatment of that element of construction.
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NCDA&CS TERMITE Pest Control Company Information RECORD NEW (Information Technology Services)

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Completed 14 August 2020

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