"Official South Carolina Wood Infestation Report Form" - South Carolina

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OFFICIAL SOUTH CAROLINA WOOD INFESTATION REPORT
Date:
_ File #:
_
THIS REPORT IS VALID FOR 30 DAYS ONLY. THIS REPORT IS NOT A GUARANTEE OR WARRANTY AGAINST FUTURE INFESTATION OR DAMAGE. IT IS
RECOMMENDED BY THE DEPARTMENT OF PESTICIDE REGULATION THAT THE PURCHASER OF THE STRUCTURE, RATHER THAN THE SELLER, OBTAIN
THIS WOOD INFESTATION REPORT.
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This is to report that a qualified inspector employed by the below named firm has carefully inspected accessible areas, including
attics and crawl spaces which permit entry, of the property located at the below address for termites, other wood-destroying organisms, and
wood-destroying fungi. The inspection for the presence of wood-destroying fungi is only required to the level below the first main floor as
defined in Section 27-1085 K(3)(f) of the Rules and Regulations for the Enforcement of the South Carolina Pesticide Control Act. This report
specifically excludes hidden areas, areas not readily accessible, and the undersigned pest control operator disclaims that he has made any
inspections of such hidden areas or of such areas not readily accessible.
The inspection described has been made on the basis of visible evidence, and special attention was given to those accessible
areas which experience has shown to be particularly susceptible to attack by wood-destroying organisms. Probing and/or sounding of those
areas and other visible and accessible wood members showing evidence of infestation was performed. This report is submitted without
warranty, guarantee, or representation as to concealed evidence of infestation or damage or as to future infestation.
If there is evidence of active infestation or past infestation of termites and/or other wood-destroying organisms or fungi, it must be
assumed that there is some damage to the building caused by this infestation; however, any visible damage to a wood member in
accessible areas has been reported. The below-named firm’s inspectors are not engineers or builders, and you may wish to call a qualified
engineer, licensed contractor, or expert in the building trade to provide their opinion as to whether there is structural damage to this property.
LOCATION AND DESCRIPTION OF PROPERTY INSPECTED:
If any of the following items are marked YES, describe on the reverse side of this page.
Were any areas of the property obstructed or inaccessible?
YES
NO
Infestation:
Active Infestation
Previous Infestation
1.
There is visible evidence of:
YES
NO
YES
NO
a.
Subterranean termites
b. Drywood termites
c.
Old house borers
d. Powder post beetles
e.
Other wood-destroying insects
YES
NO
2.
There is visible evidence of prior subterranean termite treatment
3.
There is evidence below the first main floor of the presence of
YES
NO
a.
Active wood-destroying fungi (wood moisture content ≥ 28%)
YES
NO
b. Non-active wood-destroying fungi (wood moisture content < 28%)
4.
There is evidence of the presence of excessive moisture conditions below
the first main floor (20% or above wood moisture content, standing water, etc.) YES
NO
Wood moisture content of the wooden substructure ranged from _______% to _______%
Damage: Termite, other wood-destroying insects and fungi (Note: reporting of fungi damage to wood, commonly called water
damage, decay or rot, is limited to the area below the first main floor of the structure as defined in 27-1085 K(3)(f) SCRR.)
At the time of our inspection, there were visibly damaged wooden members (e.g. insect
damage to columns, sills, joists, plates, door jambs, headers, exterior stairs, porches,
or fungi damage below the first main floor)
YES
NO
If the answer is YES, specify causes and location(s) on back.
Damage Observed: Damage must be disclosed even if repairs are deemed unnecessary. If visible evidence of active or previous infestation
caused by any wood-destroying organism is reported, it must be assumed that some degree of damage is present. Said damage and
location(s) must be described on the reverse side of this report. It is recommended that evaluation of damage and any corrections be
performed by a licensed contractor or structural engineer approved by the purchaser.
Treatment:
Check appropriate box
1. The property described was treated by us for the prevention or control of
wood-destroying organism for which treatment was made
date of treatment
2. An Official Waiver of Standards Form (subterranean termite treatment) has been issued. [NOTE: a signed
copy must be attached to this report]
3. The property is covered by a warranty associated with the above treatment. The purchaser should
contact the company regarding information required to transfer the warranty.
4. The property described has not been treated by us for any wood-destroying organisms.
See other side of this report for additional conditions governing this report. CL-100 Approved by the South Carolina Pest Control Association, Inc., and the Division of
FORM CL-100
Regulatory and Public Service Programs of Clemson University
Revised 9/12 (supersedes earlier versions)
OFFICIAL SOUTH CAROLINA WOOD INFESTATION REPORT
Date:
_ File #:
_
THIS REPORT IS VALID FOR 30 DAYS ONLY. THIS REPORT IS NOT A GUARANTEE OR WARRANTY AGAINST FUTURE INFESTATION OR DAMAGE. IT IS
RECOMMENDED BY THE DEPARTMENT OF PESTICIDE REGULATION THAT THE PURCHASER OF THE STRUCTURE, RATHER THAN THE SELLER, OBTAIN
THIS WOOD INFESTATION REPORT.
fdgfgfgfgfg
This is to report that a qualified inspector employed by the below named firm has carefully inspected accessible areas, including
attics and crawl spaces which permit entry, of the property located at the below address for termites, other wood-destroying organisms, and
wood-destroying fungi. The inspection for the presence of wood-destroying fungi is only required to the level below the first main floor as
defined in Section 27-1085 K(3)(f) of the Rules and Regulations for the Enforcement of the South Carolina Pesticide Control Act. This report
specifically excludes hidden areas, areas not readily accessible, and the undersigned pest control operator disclaims that he has made any
inspections of such hidden areas or of such areas not readily accessible.
The inspection described has been made on the basis of visible evidence, and special attention was given to those accessible
areas which experience has shown to be particularly susceptible to attack by wood-destroying organisms. Probing and/or sounding of those
areas and other visible and accessible wood members showing evidence of infestation was performed. This report is submitted without
warranty, guarantee, or representation as to concealed evidence of infestation or damage or as to future infestation.
If there is evidence of active infestation or past infestation of termites and/or other wood-destroying organisms or fungi, it must be
assumed that there is some damage to the building caused by this infestation; however, any visible damage to a wood member in
accessible areas has been reported. The below-named firm’s inspectors are not engineers or builders, and you may wish to call a qualified
engineer, licensed contractor, or expert in the building trade to provide their opinion as to whether there is structural damage to this property.
LOCATION AND DESCRIPTION OF PROPERTY INSPECTED:
If any of the following items are marked YES, describe on the reverse side of this page.
Were any areas of the property obstructed or inaccessible?
YES
NO
Infestation:
Active Infestation
Previous Infestation
1.
There is visible evidence of:
YES
NO
YES
NO
a.
Subterranean termites
b. Drywood termites
c.
Old house borers
d. Powder post beetles
e.
Other wood-destroying insects
YES
NO
2.
There is visible evidence of prior subterranean termite treatment
3.
There is evidence below the first main floor of the presence of
YES
NO
a.
Active wood-destroying fungi (wood moisture content ≥ 28%)
YES
NO
b. Non-active wood-destroying fungi (wood moisture content < 28%)
4.
There is evidence of the presence of excessive moisture conditions below
the first main floor (20% or above wood moisture content, standing water, etc.) YES
NO
Wood moisture content of the wooden substructure ranged from _______% to _______%
Damage: Termite, other wood-destroying insects and fungi (Note: reporting of fungi damage to wood, commonly called water
damage, decay or rot, is limited to the area below the first main floor of the structure as defined in 27-1085 K(3)(f) SCRR.)
At the time of our inspection, there were visibly damaged wooden members (e.g. insect
damage to columns, sills, joists, plates, door jambs, headers, exterior stairs, porches,
or fungi damage below the first main floor)
YES
NO
If the answer is YES, specify causes and location(s) on back.
Damage Observed: Damage must be disclosed even if repairs are deemed unnecessary. If visible evidence of active or previous infestation
caused by any wood-destroying organism is reported, it must be assumed that some degree of damage is present. Said damage and
location(s) must be described on the reverse side of this report. It is recommended that evaluation of damage and any corrections be
performed by a licensed contractor or structural engineer approved by the purchaser.
Treatment:
Check appropriate box
1. The property described was treated by us for the prevention or control of
wood-destroying organism for which treatment was made
date of treatment
2. An Official Waiver of Standards Form (subterranean termite treatment) has been issued. [NOTE: a signed
copy must be attached to this report]
3. The property is covered by a warranty associated with the above treatment. The purchaser should
contact the company regarding information required to transfer the warranty.
4. The property described has not been treated by us for any wood-destroying organisms.
See other side of this report for additional conditions governing this report. CL-100 Approved by the South Carolina Pest Control Association, Inc., and the Division of
FORM CL-100
Regulatory and Public Service Programs of Clemson University
Revised 9/12 (supersedes earlier versions)
File #:
CONDITIONS GOVERNING THIS REPORT
Please read carefully.
This report is based on the observations and opinions of our inspector. It must be noted that all buildings have some wood
members which are not visible or accessible for inspection. It is not always possible to determine the presence of infestation without
extensive probing and in some cases actual dismantling of parts of the structure being inspected.
All inspections and reports will be made on the basis of what is visible, and we will not render opinions covering areas that are
enclosed or not readily accessible, areas concealed by wall coverings, floor coverings, insulation, furniture, equipment, stored articles, or
any portions of the structure in which inspection would necessitate tearing out or marring finished work. We do not move furniture,
appliances, equipment, etc. Plumbing leaks may not be apparent at the time of inspection. If evidence of such leaks is disclosed, liability for
the correction of such leaks is specifically denied. No opinion can be rendered as to infestation or damage on that portion of sheathing,
siding, or other susceptible material which continues below soil grade.
The areas of the substructure and attic that are accessible and open for inspection have been inspected. The substructure is defined as
that portion of the building below the first main floor living space.
Detached garages, sheds, lean-tos, fences, or other buildings on the property are not included in this inspection report unless
specifically noted.
The company, upon specific request and agreement as to additional charge, will open any inaccessible, concealed, or enclosed area
and inspect same and make a report thereon.
This property was not inspected for the presence or absence of health related molds or fungi. This inspection was conducted solely
for visible evidence of wood destroying organisms and their damage and was limited to the visible and accessible areas of the structure(s)
only. Inspection for the presence of wood-destroying fungi is only required to the level below the first main floor. We are not qualified to
and do not render an opinion concerning mold related air quality or any other health related issues relating to this structure. Questions
concerning the presence or absence of health related molds or fungi or other health related issues, which may be associated with this
property, should be addressed to a properly trained Industrial Hygienist, Physician or Public Health Official.
REMARKS
THIS SPACE IS TO BE USED TO DETAIL ANY “YES” ANSWERS FROM THE FRONT OF THIS FORM. INCLUDE ITEM NUMBER
WITH EACH EXPLANATION. CLARIFICATION AND EXPLANATION OF OTHER ITEMS MAY ALSO BE INCLUDED.
Additional pages are attached. YES
NO
Neither I nor the company for which I am acting have had, presently have, or contemplate having any interest in this property. I do
further state that neither I nor the company for which I am acting is associated in any way with any party to this transaction.
LICENSE NUMBER OF PERSON SIGNING THIS
FIRM:
_
BY:
(MUST BE CERTIFIED IN CATEGORY 7A)
LICENSEE’S SIGNATURE
BUSINESS LICENSE NUMBER:
ADDRESS:
ACKNOWLEDGMENT:
_
PURCHASER ACKNOWLEDGES THAT A COPY OF THIS REPORT HAS BEEN REVIEWED AND RECEIVED.
DATE ACKNOWLEDGED
PURCHASER’S SIGNATURE
This report and the issuing licensee are regulated by Clemson University’s Department of Pesticide Regulation.
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