Form FDACS-13642 "Special Training to Perform Wood-Destroying Organism Inspections and Control Training Verification Record" - Florida

What Is Form FDACS-13642?

This is a legal form that was released by the Florida Department of Agriculture and Consumer Services - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2015;
  • The latest edition provided by the Florida Department of Agriculture and Consumer Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form FDACS-13642 by clicking the link below or browse more documents and templates provided by the Florida Department of Agriculture and Consumer Services.

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Download Form FDACS-13642 "Special Training to Perform Wood-Destroying Organism Inspections and Control Training Verification Record" - Florida

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Florida Department of Agriculture and Consumer Services
Respond to:
Division of Agricultural Environmental Services
Bureau of Licensing and
Enforcement
SPECIAL TRAINING TO PERFORM
3125 Conner Blvd, Bldg 8,
Tallahassee, FL 32399-1650
WOOD-DESTROYING ORGANISM
INSPECTIONS AND CONTROL
NICOLE "NIKKI" FRIED
COMMISSIONER
TRAINING VERIFICATION RECORD
Sections 482.091 and 482.226, F.S. and Rule 5E-14.1421, F.A.C.
Telephone: (850) 617-7997
This Form is NOT required of Certified Operators who are certified in the category of TERMITE OR OTHER WOOD-DESTROYING
ORGANISM CONTROL.
DATE: ______________________________
COMPANY NAME ____________________________________________ LICENSE NUMBER ______________________
ADDRESS ________________________________________________________________________________________
_________________________________________________________________________________________________
EMAIL ADDRESS
: _____________________________________________________________________________________________________
The below named applicant:
NAME: __________________________________________________________________________________________________________________
(First Name)
(Middle Name)
(Last Name)
who resides at
(Street or rural address)
(City)
(State)
(Zip)
Telephone Number: _________________________________________________________________________________________________________
Florida Driver’s License Number (or State ID Number): ______________________________________________________________________________
Date of Birth: _______________________________________________
(mm/dd/yyyy)
Has received adequate training in the proper detection and control of wood-destroying organisms under the supervision of a Certified
Operator, certified in the termite and other wood-destroying organisms category.
I further certify that such training included the following:
(a) The biology, behavior, and identification of wood-destroying organisms with particular emphasis on those common to the
State of Florida and the damage caused by such organisms;
(b) The inspection forms to be used to report the inspection findings; and
(c) Applicable federal, state and local laws and ordinances.
The applicant has been informed and understands that he/she cannot perform wood-destroying organism inspections unless under the
supervision of a certified operator in charge who is certified in the category of termite and other wood-destroying organism control.
The applicant has also been informed and understands that a Wood-Destroying Organisms Identification Card shall be used in
accordance with the provisions of Sections 482.091 and 482.226, Florida Statutes.
Signature of prospective Identification Cardholder
Signature of Certified Operator in Charge
ID Card Number (if applicable)
Title or Position
FDACS-13642 Rev. 10/15
Florida Department of Agriculture and Consumer Services
Respond to:
Division of Agricultural Environmental Services
Bureau of Licensing and
Enforcement
SPECIAL TRAINING TO PERFORM
3125 Conner Blvd, Bldg 8,
Tallahassee, FL 32399-1650
WOOD-DESTROYING ORGANISM
INSPECTIONS AND CONTROL
NICOLE "NIKKI" FRIED
COMMISSIONER
TRAINING VERIFICATION RECORD
Sections 482.091 and 482.226, F.S. and Rule 5E-14.1421, F.A.C.
Telephone: (850) 617-7997
This Form is NOT required of Certified Operators who are certified in the category of TERMITE OR OTHER WOOD-DESTROYING
ORGANISM CONTROL.
DATE: ______________________________
COMPANY NAME ____________________________________________ LICENSE NUMBER ______________________
ADDRESS ________________________________________________________________________________________
_________________________________________________________________________________________________
EMAIL ADDRESS
: _____________________________________________________________________________________________________
The below named applicant:
NAME: __________________________________________________________________________________________________________________
(First Name)
(Middle Name)
(Last Name)
who resides at
(Street or rural address)
(City)
(State)
(Zip)
Telephone Number: _________________________________________________________________________________________________________
Florida Driver’s License Number (or State ID Number): ______________________________________________________________________________
Date of Birth: _______________________________________________
(mm/dd/yyyy)
Has received adequate training in the proper detection and control of wood-destroying organisms under the supervision of a Certified
Operator, certified in the termite and other wood-destroying organisms category.
I further certify that such training included the following:
(a) The biology, behavior, and identification of wood-destroying organisms with particular emphasis on those common to the
State of Florida and the damage caused by such organisms;
(b) The inspection forms to be used to report the inspection findings; and
(c) Applicable federal, state and local laws and ordinances.
The applicant has been informed and understands that he/she cannot perform wood-destroying organism inspections unless under the
supervision of a certified operator in charge who is certified in the category of termite and other wood-destroying organism control.
The applicant has also been informed and understands that a Wood-Destroying Organisms Identification Card shall be used in
accordance with the provisions of Sections 482.091 and 482.226, Florida Statutes.
Signature of prospective Identification Cardholder
Signature of Certified Operator in Charge
ID Card Number (if applicable)
Title or Position
FDACS-13642 Rev. 10/15