"Waiver of Requirements of Minimum Specifications for Termite Control Work" - Louisiana

Waiver of Requirements of Minimum Specifications for Termite Control Work is a legal document that was released by the Louisiana Department of Agriculture & Forestry - a government authority operating within Louisiana.

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STATE OF LOUISIANA
Department of Agriculture & Forestry – Structural Pest Control Commission
Waiver of Requirements of Minimum Specifications for Termite Control Work
PROPERTY OWNER:
PEST CONTROL COMPANY:
ADDRESS/CITY/STATE:
PEST CONTROL COMPANY ADDRESS:
PHONE:
PEST CONTROL COMPANY PHONE:
LOCATION OF PROPERTY, IF DIFFERENT FROM ABOVE:
DATE OF CONTRACT:
TREATMENT TYPE
INITIAL:
RETREAT:
CONSTRUCTION TYPE
SLAB:
PIER:
LAC 7XXV 141(H) - Waiver of Requirements of Minimum Specifications for Termite Control Work: A pest control operator may request from the owner/agent of the structure(s) to be
treated, a waiver of the requirements set out in these regulations whenever it is impossible or impractical to treat one or more areas of the structure in accordance with these minimum
specifications for initial treatment/retreat. The waiver shall be signed by the owner/agent of the structure(s) to be treated prior to or during treatment. A signed copy of the waiver shall
be given to the owner/agent and shall be sent to the department with the company’s monthly eradication report. The waiver shall include, but not be limited to, the following
information: a. graph identifying the structure and the specific area(s) where treatment is waived; b. a description of each area where treatment is waived; and c. for each area, the
reason treatment is being waived.
PART A: The items checked below apply to the structure listed above and will not be performed in treating the property to minimum standards. Any item
checked below must be explained on the right adjacent to the item checked on the left with location noted on the graph in Part B on the back page or on a
separate document as noted.
Minimum Specifications: Provide explanations & locations of item(s) waived. Check box to the right if waiver is per the customer’s request. Customer must
initial next to the box.
Customer Initial
A. Access openings ____________________________________________________________________________________
_____
____________________________________________________________________________________________________
____________________________________________________________________________________________________
B. Required clean-up ___________________________________________________________________________________
_____
____________________________________________________________________________________________________
____________________________________________________________________________________________________
C. Elimination of direct contact of wood with ground ___________________________________________________________
_____
____________________________________________________________________________________________________
____________________________________________________________________________________________________
D. Pipes _____________________________________________________________________________________________
_____
____________________________________________________________________________________________________
____________________________________________________________________________________________________
E. Skirting and Lattice-Work ______________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
F. Stucco _____________________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
G. Masonry ___________________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
H. Ground treatment ____________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
I. Dirt filled porches _____________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
J. Bath Traps __________________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
K. Other openings in slab ________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
L. Other – (please list)___________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
PART B: A graph indicating the area(s) noted on this page that have not been treated to minimum standards is required. Please indicate where the
graph is drawn and provide a copy to property owner.
Document where graph is drawn: ______________________________________________________________________________________________
Comments:
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Property owner/agent: Do not sign this form if you do not understand the items being waived or if you have any questions regarding the quality or
extend of treatment being performed.
LICENSEE/TECHNICIAN:
LICENSEE/TECHNICIAN #:
SIGNATURE OF LICENSEE/TECHNICIAN:
SIGNATURE OF OWNER/AGENT:
DATE:
Original to Pest Control Operator. Customer must be provided a copy.
Property Owner Initial_____________
STATE OF LOUISIANA
Department of Agriculture & Forestry – Structural Pest Control Commission
Waiver of Requirements of Minimum Specifications for Termite Control Work
PROPERTY OWNER:
PEST CONTROL COMPANY:
ADDRESS/CITY/STATE:
PEST CONTROL COMPANY ADDRESS:
PHONE:
PEST CONTROL COMPANY PHONE:
LOCATION OF PROPERTY, IF DIFFERENT FROM ABOVE:
DATE OF CONTRACT:
TREATMENT TYPE
INITIAL:
RETREAT:
CONSTRUCTION TYPE
SLAB:
PIER:
LAC 7XXV 141(H) - Waiver of Requirements of Minimum Specifications for Termite Control Work: A pest control operator may request from the owner/agent of the structure(s) to be
treated, a waiver of the requirements set out in these regulations whenever it is impossible or impractical to treat one or more areas of the structure in accordance with these minimum
specifications for initial treatment/retreat. The waiver shall be signed by the owner/agent of the structure(s) to be treated prior to or during treatment. A signed copy of the waiver shall
be given to the owner/agent and shall be sent to the department with the company’s monthly eradication report. The waiver shall include, but not be limited to, the following
information: a. graph identifying the structure and the specific area(s) where treatment is waived; b. a description of each area where treatment is waived; and c. for each area, the
reason treatment is being waived.
PART A: The items checked below apply to the structure listed above and will not be performed in treating the property to minimum standards. Any item
checked below must be explained on the right adjacent to the item checked on the left with location noted on the graph in Part B on the back page or on a
separate document as noted.
Minimum Specifications: Provide explanations & locations of item(s) waived. Check box to the right if waiver is per the customer’s request. Customer must
initial next to the box.
Customer Initial
A. Access openings ____________________________________________________________________________________
_____
____________________________________________________________________________________________________
____________________________________________________________________________________________________
B. Required clean-up ___________________________________________________________________________________
_____
____________________________________________________________________________________________________
____________________________________________________________________________________________________
C. Elimination of direct contact of wood with ground ___________________________________________________________
_____
____________________________________________________________________________________________________
____________________________________________________________________________________________________
D. Pipes _____________________________________________________________________________________________
_____
____________________________________________________________________________________________________
____________________________________________________________________________________________________
E. Skirting and Lattice-Work ______________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
F. Stucco _____________________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
G. Masonry ___________________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
H. Ground treatment ____________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
I. Dirt filled porches _____________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
J. Bath Traps __________________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
K. Other openings in slab ________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
L. Other – (please list)___________________________________________________________________________________
_____
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
PART B: A graph indicating the area(s) noted on this page that have not been treated to minimum standards is required. Please indicate where the
graph is drawn and provide a copy to property owner.
Document where graph is drawn: ______________________________________________________________________________________________
Comments:
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Property owner/agent: Do not sign this form if you do not understand the items being waived or if you have any questions regarding the quality or
extend of treatment being performed.
LICENSEE/TECHNICIAN:
LICENSEE/TECHNICIAN #:
SIGNATURE OF LICENSEE/TECHNICIAN:
SIGNATURE OF OWNER/AGENT:
DATE:
Original to Pest Control Operator. Customer must be provided a copy.
Property Owner Initial_____________