"Waiver Form for Waiver of Minimum Requirements for Subterranean Termite Control" - Alabama

Waiver Form for Waiver of Minimum Requirements for Subterranean Termite Control is a legal document that was released by the Alabama Department of Agriculture and Industries - a government authority operating within Alabama.

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OFFICIAL STATE OF ALABAMA
WAIVER FORM
FOR WAIVER OF MINIMUM REQUIREMENTS FOR SUBTERRANEAN
TERMITE CONTROL (Part "A")
(Note: Form Consists of Part "A" and Part "B" both pages must be completed)
Rule 80 - 10 - 9 - .16, Subparagraph (4)
Whenever it is impossible or impractical to treat one or more areas of the structure in accordance with the minimum requirements for
the control of subterranean termites as set forth in Rule 80 - 10 - 9 - .20, the Official State of Alabama Waiver Form shall be used.
Notation of any deviation from these requirements for subterranean termite treatment as set forth in Rule 80 - 10 - 9 .20, shall be
explained in the Waiver Form and must be signed by the owner/agent of the structure(s) to be treated prior to treatment. A signed copy
of the Waiver Form shall be given to the owner/agent of the structure and shall become a part of the subterranean termite contract. Any
subsequent owner/agent of the structure shall be provided a copy of the said Waiver Form for the transfer of any subterranean termite
guarantee or contract. Structures where a baiting system has been applied in lieu of a comprehensive post construction soil treatment
will be required to meet minimum requirements for control of subterranean termites as set forth in Rule 80-10-9-.20, except for
subparagraphs (6), (7), and (8). Structures where a defined post construction soil treatment has been applied in lieu of a comprehensive
post construction soil treatment will be required to meet minimum requirements for control of subterranean termites as set forth in
Rule 80-10-9-.20, with exception(s) for subparagraphs (6) and (8).
NOTICE TO PROPERTY OWNERS:
DO NOT SIGN THIS DOCUMENT UNTIL YOU HAVE READ AND SIGNED "CONDITIONS
GOVERNING THE USE OF THE WAIVER FORM" ON PART "B" OF THIS DOCUMENT. THESE "CONDITIONS" MUST BE
CONSIDERED PART OF THIS DOCUMENT. YOU MUST RECEIVE A COPY OF THIS REPORT AND SUPPORTING GRAPH. *PLEASE
ONLY PLACE YOUR INITIALS NEXT TO THE TREATMENT REQUIREMENTS THAT ARE CHECKED "NO".
PERMITTEE TREATING PROPERTY:
PERMIT #:
(
)
PERMITTEE'S ADDRESS:
(Street)
(City)
(zip)
(Phone)
PROPERTY OWNER:
(
)
PROPERTY ADDRESS:
(Street)
(City)
(zip)
(Phone)
Requirements for Soil Barrier termite treatments in addition to treatment specifications of label and labeling: NOTE: TREATMENT
MUST BE CONSISTENT WITH PRODUCT LABEL AND LABELING.
(Check One) COMPREHENSIVE POST CONSTRUCTION
DEFINED POST CONSTRUCTION
*Property
owner
Date Job Completed?
Yes
No N/A
Initial
(1) Access Openings. Suitable access provided and/or available to all areas requiring inspection and treatment.
(2) Sanitation. All cellulose debris removed form crawl space and next to the structure(s).
(3) Clearance. Minimum clearance between wood and soil in crawl space will be 8" for girders & 12" for joist.
(4) Wood-to-Ground Contacts. All wood-to-ground contacts underneath and outside of structure broken and
wood insulated from soil with at least (4) inches of concrete or other material impervious to termites.
(5) Termite Tunnels. All termite tunnels scraped from all structural elements below sill line.
(6) Treatment of Voids. All cracks and voids adequately drilled and treated.
(7) Treatment of Dirt-filled Areas. All dirt-filled structures such as porches, carports, driveways, terraces and
other similar structures attached to the building were either drilled, rodded, or voided and treated.
Requirements for Non Soil Pesticides, Device, Bait or Baiting System - NOTE: TREATMENT MUST BE CONSISTENT WITH
PRODUCT LABEL AND LABELING.
Type Treatment Provided:
*Property
Date Job Completed?
owner
Yes
No N/A
Initial
(1) Access opening adequate
(2) All debris removed
(3) Adequate clearance present or provided
(4) Wooden contacts removed
(5) Termite tunnels removed (except at locations where an above ground bait device is installed)
Explain in detail what areas of the structure do not meet treatment standards and why it is not possible to meet these treatment
standards. Simple statements such as "Owner did not want work performed" are not considered valid explanations. Also, complete
the graph on Part "B" of this form indicating the area(s) that were not treated to minimum standards. Failure to complete Parts "A
& B" of this Waiver form and provide a detailed written explanation will void this document.
Signature of Property Owner(s)
Date
Signature of Permittee or Agent.
Date
Signature of New Property Owner(s) if issued during a real estate transaction
Date
OFFICIAL STATE OF ALABAMA
WAIVER FORM
FOR WAIVER OF MINIMUM REQUIREMENTS FOR SUBTERRANEAN
TERMITE CONTROL (Part "A")
(Note: Form Consists of Part "A" and Part "B" both pages must be completed)
Rule 80 - 10 - 9 - .16, Subparagraph (4)
Whenever it is impossible or impractical to treat one or more areas of the structure in accordance with the minimum requirements for
the control of subterranean termites as set forth in Rule 80 - 10 - 9 - .20, the Official State of Alabama Waiver Form shall be used.
Notation of any deviation from these requirements for subterranean termite treatment as set forth in Rule 80 - 10 - 9 .20, shall be
explained in the Waiver Form and must be signed by the owner/agent of the structure(s) to be treated prior to treatment. A signed copy
of the Waiver Form shall be given to the owner/agent of the structure and shall become a part of the subterranean termite contract. Any
subsequent owner/agent of the structure shall be provided a copy of the said Waiver Form for the transfer of any subterranean termite
guarantee or contract. Structures where a baiting system has been applied in lieu of a comprehensive post construction soil treatment
will be required to meet minimum requirements for control of subterranean termites as set forth in Rule 80-10-9-.20, except for
subparagraphs (6), (7), and (8). Structures where a defined post construction soil treatment has been applied in lieu of a comprehensive
post construction soil treatment will be required to meet minimum requirements for control of subterranean termites as set forth in
Rule 80-10-9-.20, with exception(s) for subparagraphs (6) and (8).
NOTICE TO PROPERTY OWNERS:
DO NOT SIGN THIS DOCUMENT UNTIL YOU HAVE READ AND SIGNED "CONDITIONS
GOVERNING THE USE OF THE WAIVER FORM" ON PART "B" OF THIS DOCUMENT. THESE "CONDITIONS" MUST BE
CONSIDERED PART OF THIS DOCUMENT. YOU MUST RECEIVE A COPY OF THIS REPORT AND SUPPORTING GRAPH. *PLEASE
ONLY PLACE YOUR INITIALS NEXT TO THE TREATMENT REQUIREMENTS THAT ARE CHECKED "NO".
PERMITTEE TREATING PROPERTY:
PERMIT #:
(
)
PERMITTEE'S ADDRESS:
(Street)
(City)
(zip)
(Phone)
PROPERTY OWNER:
(
)
PROPERTY ADDRESS:
(Street)
(City)
(zip)
(Phone)
Requirements for Soil Barrier termite treatments in addition to treatment specifications of label and labeling: NOTE: TREATMENT
MUST BE CONSISTENT WITH PRODUCT LABEL AND LABELING.
(Check One) COMPREHENSIVE POST CONSTRUCTION
DEFINED POST CONSTRUCTION
*Property
owner
Date Job Completed?
Yes
No N/A
Initial
(1) Access Openings. Suitable access provided and/or available to all areas requiring inspection and treatment.
(2) Sanitation. All cellulose debris removed form crawl space and next to the structure(s).
(3) Clearance. Minimum clearance between wood and soil in crawl space will be 8" for girders & 12" for joist.
(4) Wood-to-Ground Contacts. All wood-to-ground contacts underneath and outside of structure broken and
wood insulated from soil with at least (4) inches of concrete or other material impervious to termites.
(5) Termite Tunnels. All termite tunnels scraped from all structural elements below sill line.
(6) Treatment of Voids. All cracks and voids adequately drilled and treated.
(7) Treatment of Dirt-filled Areas. All dirt-filled structures such as porches, carports, driveways, terraces and
other similar structures attached to the building were either drilled, rodded, or voided and treated.
Requirements for Non Soil Pesticides, Device, Bait or Baiting System - NOTE: TREATMENT MUST BE CONSISTENT WITH
PRODUCT LABEL AND LABELING.
Type Treatment Provided:
*Property
Date Job Completed?
owner
Yes
No N/A
Initial
(1) Access opening adequate
(2) All debris removed
(3) Adequate clearance present or provided
(4) Wooden contacts removed
(5) Termite tunnels removed (except at locations where an above ground bait device is installed)
Explain in detail what areas of the structure do not meet treatment standards and why it is not possible to meet these treatment
standards. Simple statements such as "Owner did not want work performed" are not considered valid explanations. Also, complete
the graph on Part "B" of this form indicating the area(s) that were not treated to minimum standards. Failure to complete Parts "A
& B" of this Waiver form and provide a detailed written explanation will void this document.
Signature of Property Owner(s)
Date
Signature of Permittee or Agent.
Date
Signature of New Property Owner(s) if issued during a real estate transaction
Date
OFFICIAL STATE OF ALABAMA
WAIVER FORM
FOR WAIVER OF MINIMUM REQUIREMENTS FOR SUBTERRANEAN
TERMITE CONTROL (Part "B")
(Note: Form Consists of Part "A" and Part "B" both pages must be completed)
CONDITIONS GOVERNING THE USE OF THE WAIVER FORM
1. The Waiver Form, For Waiver of Minimum Requirements for Subterranean Termite Control, is intended
to be used ONLY in situations where it is not possible or practical to meet the minimum treatment standards
established by the Alabama Department of Agriculture & Industries..
2. The Waiver Form is not to be used to bypass the minimum treatment standards nor is it used to notify any
agency of government that subterranean termite work has been completed. The graph on this form shall not
be used for the grafting requirements of Rule 80-10-9-.16(3)(f).
3. By signing this document the property owner acknowledges that the property identified will not receive a
complete minimum treatment. Signing this document does not affect the terms of any guarantee between the
property owner and the pest control company.
4. Each "no" must be initialed by the property owner and explained in detail in the area provided on Part "A"
and identified on the Graph on Part "B" of this document as to specifically what areas of the structure do not
meet the treatment standards and why it is not possible to meet these treatment standards. Additional space is
provided below.
5. All sections of Part "A & B" of this document must be filled out completely. Failure to comply with this
requirement or failure to provide the explanation required in "Condition #4" above will constitute a violation
involving misuse of this form and may render it void.
Additional Explanations:
GRAPH KEYS : Use the numbers and abbreviated Keys in the corresponding areas of the graph where items are being waived.
(1)
(2)
(3)
(4)
(5)
(6)
 ACCESS OPENINGS
 SANITATION
 CLEARANCE
 WOOD TO EARTH CONTACT
 TERMITE TUNNELS
 TREATMENT OF VOIDS
(7)
 TREATMENT OF DIRT-FILLED AREAS
(EIFS)
(BR)
(F-SL)
(S-SL)
(MONO)
(BMNT)
 EIFS
 BRICK
 FLOATING SLAB
 SUPPORTED SLAB
 MONOLITHIC SLAB
 BASEMENT
(BL)
(CRL)
(SS-P)
(FS-P)
(CHIM)
 OTHER:
 BLOCK
 CRAWL SPACE
 SUSPENDED SLAB PORCH
 FILLED SLAB PORCH
 CHIMNEY
Signature of Property Owner
Date
Signature of Permittee or Agent.
Date
Signature of New Property Owner(s) if issued during a real estate transaction
Date
Note: This form consists of Part "A" and Part "B" and both parts ("A & B") must signed by the Property
Owner/Agent and the Permittee/Agent and both parts become part of the contract. If either part ("A or B")
are missing or not properly signed will render the Waiver Form void.
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