Date: / Inspection: RoutineRequested By HomeownerRequested by PCOTermite Pretreatment
Name and Address of Property Inspected. / Subterranean Termites: / Active No Visible Activity
Drywood Termites: / Active No Visible Activity
Anobiidae Beetles: / Active No Visible Activity
Lyctidae Beetles: / Active No Visible Activity
Old House Borers: / Active No Visible Activity
Beetle Activity found: N/AAt or Below SubfloorAbove SubfloorBelow and Above Subfloor
Other Structural Pest(s) Active:
Name and Address of Pest Control Company. / Property Under Contract For: TermitesBeetlesTermites and BeetlesNOT UNDER CONTRACT
Contract Date:
Chemical(s) Used:
Date WDIR was Issued:
Owner Received Copy of: Contract Graph WDIR
Construction Type: CrawlBasementMonolithic SlabSupported SlabFloating Slab
Company Representative Present: Yes No
COMPLETE NUMBERS 1 THROUGH 9 FOR CRAWL AND BASEMENT STRUCTURES
COMPLETE NUMBERS 10 THROUGH 14 FOR SLAB STRUCTURES

CRAWL SPACE

1. Termite tunnels scraped from foundation walls and pillars: YESNO
2. Cellulose debris present: NONESMALL AMOUNTLARGE AMOUNT
3. Clearance between soil and non pressure treated wood: MORE THAN 6 INCHESLESS THAN 6 INCHESCONTACTS SOIL
4. Foundation walls: OPEN WALL / Trenched or rodded: Inside - YESPARTLYNO Outside - YESPARTLYNO
Solid concrete footing above grade level: YESNO
Walls capped with solid concrete: YESNO
Double or triple masonry walls: NOT PRESENTPRESENT; DRILLEDPRESENT; PARTLY DRILLEDPRESENT; NOT DRILLED
Hollow masonry blocks: OPEN AT TOPNOT PRESENTPRESENT; DRILLEDPRESENT; PARTLY DRILLEDPRESENT; NOT DRILLED
5. Pillars: / Trenched or rodded: YESPARTLYNO
Solid Concrete Footing above grade: YESNO
Double brick or larger: NOT PRESENTPRESENT; DRILLEDPRESENT; PARTLY DRILLEDPRESENT; NOT DRILLED
Hollow masonry blocks: OPEN AT TOPNOT PRESENTPRESENT; DRILLEDPRESENT; PARTLY DRILLEDPRESENT; NOT DRILLED
6. Chimney(s): NOT PRESENTPRESENT
Number Present: / Excavated: YESNO
Trenched or Rodded: YESPARTLYNO
Drilled: YESNO
7. Dirt filled porch: NOT PRESENTPRESENT
Number Present; / Excavated: YESNO
Trenched or Rodded: YESPARTLYNO
Drilled: YESNO
8. Slab(s) adjacent to structure with expansion joints: NOT PRESENTYES; DRILLEDYES; PARTLY DRILLEDYES; NOT DRILLED
9. Pipes Present: YESNO; Trenched or Rodded: YESPARTLYNO
SLAB
10. Perimeter of slab rodded or trenched: YESPARTLYNO
11. Bath traps and other openings treated: YESNON/A
12. Expansion joints and visible cracks: NOT PRESENTPRESENT; DOWNDRILLEDPRESENT; NOT DOWNDRILLED ; RODDEDNOT RODDED
13. Masonry foundation walls below soil line: NOT PRESENTPRESENT; DRILLEDPRESENT; PARTLY DRILLEDPRESENT; NOT DRILLED
14. Slab(s) adjacent to structure with expansion joints: NOT PRESENTPRESENT; DRILLEDPRESENT; PARTLY DRILLEDPRESENT; NOT DRILLED

TERMITE AND OTHER STRUCTURAL PEST INSPECTION REPORT 6/02 KC/JC

Regulatory Action Required:

Inspector:

CHECK THE NUMBER OF THE ITEM(S) TREATMENT IS DEFICIENT AND LIST ANY OTHER DISCREPANCIES UNDER REMARKS

COMPLETE GRAPH FOR ALL REQUESTED STRUCTURAL INSPECTIONS

X = VISIBLE SUBTERRANEAN TERMITE DAMAGE = ACTIVE SUBTERRANEAN TERMITES

B = WOOD BORING BEETLE DAMAGE = ACTIVE WOOD BORING BEETLES

D = DRYWOOD TERMITE DAMAGE = ACTIVE DRYWOOD TERMITES

C = CONDITIONS CONDUCIVE TO WOOD DESTROYING INSECTS

REMARKS: