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OFFICIAL WAIVER 9F MINIMUM REQUIREMENTS FOR THE
k 'CONTROL OF SUBTERRANEAN IN EXISTING STRUCTURES
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Bafora i�igntng this form you should read and uniterstand �acfl of the traatm�snt specifications indicted below. These specifications see
based on the minimum requirement of.the N.C. Strupttarai Pest ControipCommlttse.
The items checked below apply to the structure to be treated and will not be performed in treating the property listed above. Any item checked
below must be explained in the area below this listing.
1. Mechanical Alterations/Sanitation: U H. Drill and treat with a termiticide voids in porch walls.
U A. Provide access openings to permit inspection of ali basement and
crawl space areas.
III. Slab Treatment:
Q B. Remove all wood and cellulose materials, such as stumps, form
boards and construction debris, contacting soil in all crawl -space ci I. Drill and treat all concrete slab porches as required.
areas.
U J. Where concrete slabs other than porches, such as walkways,
❑ C, Provide required clearance between soil and wood floor Joints, carports and patios, which`prevent trenching soil adjacent to
girders and subsilis. "Iau ichih6n elements, drill slab and treat soil beneath slab.
U D. Remove all visible tubes or tunnels on the foundation and other U K. Treat soil with a termiticide beneath floor slabs, such as garages, ;
structures below the sill line. storage rooms and interior floor slabs.
J E. Remove all wooden contacts between the bullding,and soil both
outside and inside except those which are pressure treated. IV, Soil Treatment:
ll. Foundation Treatment: .' i .
L, Treat soil with a termiticlde'adjacent to all foundation elements,
0 F. Drift and treat with a termiticida all voids in multiple masonry pillars, pipes and other utility conduits both inside and outside the
pilasters, chimney% and step buttresses within 4 feet of any foundation wall. (if slabs adjacent to the foundation wall prevent
evidence of termites. trenching, see "Slab Treatment J" above.)
V. Service Agreement Information:
This treatment is ___ Is not _covered by a service agreement (one must be checked), If a service agreement is to he issued, s+ Neva
is attached to these specifications,
Reasons for not following minimum requirements checked above. (Identify and explain each requirement separately.)
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Annual renewal payment
Sales # .
st Defense will treat this structure according to the minimum requirements of the North Carolina
and I authorized the above company to i
its.1 also under nd thai 4Vttgo Post ones I not responstbte for any damage to the promises
Ity cau during th -tree#men# application, or that ttson PastDefense has no liability for the
r� to the structure, or its contan#s, caused y Subterranean Termites and/or Powder Post Beetles.
Leasse No.: ucensoa: -.
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)lei 'EST DEF'ENS]
After Receipt of Signed Copy Frorr
When Accepted by INItcon Past De
Two Parties,
Form No. 5 (Revised Etteouve March 1, 1999)
sw/Authorized Agent, This Proposal
Becomes A Contract Between The . t.
IJNIDE STAND IT ON IF YOU HAVE ANY QUESTIONS REGARDING ,THE,
ON A BLANK FORM.
Data:
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This date must not be later than 30 days from the date of the job
:ontract to which this waiver applies.)