Termite Pretreatment Notification 

   NOTIFICATION OF INTENT TO CONDUCT PRECONSTRUCTION TREATMENTS

PEST CONTROL COMPANY INFORMATION
*Company Name:     *Date form submitted:  
Contact:   Company Number:  
E-Mail Address:   *Phone/Extension:  


 

PEST CONTROL COMPANY INFORMATION
Per NAC 555.427 A complete "Termite Pretreatment Notification Form" must be submitted to the Nevada Department of Agriculture before performing a preconstruction treatment.

    Indicate Application details below:

*Site (subdivision) Name:  
*Location or address (including zip code)  Address: 
 City:             State:    Zip:     
Major Cross Streets:     Builder / Contractor Name:  
*Expected Starting Date:   *Expected Completion Date:  
*Number of sites that will be treated:   *Treatment Type:    SOIL
   WOOD
*Location of NDOA "Pre-treatment Tag" (green) will be placed:    PLUMBING STUB-OUT                INSIDE ELECTRICAL PANEL
   FOUNDATION WALL                    OTHER 
                                                                   Other placement:

Fields marked with * are required.

 

 
 
 
 

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