Texas Termite Forms Details

Have you ever seen a group of insects clustered together and wondered what they were? If so, you're not alone! Many people are curious about the insect world, but don't know where to start when it comes to identifying them. In this blog post, we'll discuss one common type of insect cluster – wood report insects. We'll define what these creatures are, provide some information about their habits and biology, and offer advice on how to deal with them if they become a nuisance.

You could find it helpful to know the amount of time you will need to prepare this wood report insects and how lengthy this document is.

QuestionAnswer
Form NameWood Report Insects
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namestexas inspection insects, wood destroying insect texas, wdi report form, wood destroying insect reports

Form Preview Example

 

TEXAS OFFICIAL WOOD DESTROYING INSECT REPORT

 

Page 1 of 2

 

 

 

 

 

 

 

Inspected Address

 

 

City

 

Zip Code

SCOPE OF INSPECTION

A.This inspection covers only the multi-family structure, primary dwelling or place of business. Sheds, detached garages, lean-tos, fences, guest houses or any other structure will not be included in this inspection report unless specifically noted in Section 5 of this report.

B.This inspection is limited to those parts of the structure(s) that are visible and accessible at the time of the inspection. Examples of inaccessible areas include but are not limited to (1) areas concealed by wall coverings, furniture, equipment and stored articles and (2) any portion of the structure in which inspection would necessitate removing or defacing any part of the structure(s) (including the surface appearance of the structure). Inspection does not cover any condition or damage which was not visible in or on the structure(s) at time of inspection but which may be revealed in the course of repair or replacement work.

C.Due to the characteristics and behavior of various wood destroying insects, it may not always be possible to determine the presence of infestation without defacing or removing parts of the structure being inspected. Previous damage to trim, wall surface, etc., is frequently repaired prior to the inspection with putty, spackling, tape or other decorative devices. Damage that has been concealed or repaired may not be visible except by defacing the surface appearance. The WDI inspecting company cannot guarantee or determine that work performed by a previous pest control company, as indicated by visual evidence of previous treatment; has rendered the pest(s) inactive.

D.If visible evidence of active or previous infestation of listed wood destroying insects is reported, it should be assumed that some degree of damage is present.

E.If visible evidence is reported, it does not imply that damage should be repaired or replaced. Inspectors of the inspection company usually are not engineers

or builders qualified to give an opinion regarding the degree of structural damage. Evaluation of damage and any corrective action should be performed by a qualified expert.

F.THIS IS NOT A STRUCTURAL DAMAGE REPORT OR A WARRANTY AS TO THE ABSENCE OF WOOD DESTROYING INSECTS.

G.If termite treatment (including pesticides, baits or other methods) has been recommended, the treating company must provide a diagram of the structure(s)

inspected and proposed for treatment, label of pesticides to be used and complete details of warranty (if any). At a minimum, the warranty must specify which areas of the structure(s) are covered by warranty, renewal options and approval by a certified applicator in the termite category. Information regarding treatment and any warranties should be provided by the party contracting for such services to any prospective buyers of the property. The inspecting company has no duty to provide such information to any person other than the contracting party.

H.There are a variety of termite control options offered by pest control companies. These options will vary in cost, efficacy, areas treated, warranties, treatment techniques and renewal options.

I.There are some specific guidelines as to when it is appropriate for corrective treatment to be recommended. Corrective treatment may only be recommended if (1) there is visible evidence of an active infestation in or on the structure, (2) there is visible evidence of a previous infestation with no evidence of a prior treatment.

J.If treatment is recommended based solely on the presence of conducive conditions, a preventive treatment or correction of conducive conditions may be recommended. The buyer and seller should be aware that there may be a variety of different strategies to correct the conducive condition(s). These corrective measures can vary greatly in cost and effectiveness and may or may not require the services of a licensed pest control operator. There may be instances where the inspector will recommend correction of the conducive conditions by either mechanical alteration or cultural changes. Mechanical

alteration may be in some instances the most economical method to correct conducive conditions. If this inspection report recommends any type of treatment and you have any questions about this, you may contact the inspector involved, another licensed pest control operator for a second opinion, and/or the Structural Pest Control Service of the Texas Department of Agriculture.

1A.

 

1B.

 

 

 

 

 

 

 

 

 

Name of Inspection Company

 

 

 

 

 

SPCS Business License Number

 

 

 

 

 

1C.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address of Inspection Company

 

City

State

Zip

 

 

Telephone No.

 

1D.

 

 

 

 

1.E

Certified Applicator

[

]

 

(check one)

 

 

 

Name of Inspector (Please Print)

 

 

 

 

 

Technician

[

]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

3.

 

 

 

 

 

 

 

 

 

 

 

Case Number (VA/FHA/Other)

 

 

 

 

 

Inspection Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4A.

 

Seller [ ] Agent

[ ] Buyer [ ] Management Co. [ ] Other

[ ]

 

 

 

 

 

Name of Person Purchasing Inspection

 

 

 

 

 

 

 

 

 

 

 

 

4B.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Owner/Seller

 

 

 

 

 

 

 

 

 

 

 

 

4C.REPORT FORWARDED TO: Title Company or Mortgagee [ ]

Purchaser of Service [ ]

Seller [ ]

Agent [ ]

 

 

Buyer [ ]

 

(Under the Structural Pest Control regulations only the purchaser of the service is required to receive a copy)

The structure(s) listed below were inspected in accordance with the official inspection procedures adopted by the Texas Department of Agriculture Structural Pest Control Service. This report is made subject to the conditions listed under the Scope of Inspection. A diagram must be attached including all structures inspected.

5.

List structure(s) inspected that may include residence, detached garages and other structures on the property. (Refer to Part A, Scope of Inspection)

6A.Were any areas of the property obstructed or inaccessible?

 

 

Yes

[ ]

 

 

No

[ ]

 

 

 

(Refer to Part B & C, Scope of Inspection)

If “Yes” specify in 6B.

 

 

 

 

 

 

 

 

 

 

 

6B.The obstructed or inaccessible areas include but are not limited to the following:

 

 

 

 

 

 

 

 

Attic

[

]

Insulated area of attic

[

]

Plumbing Areas

[

]

Planter box abutting structure

[

]

 

Deck

[

]

Sub Floors

[

]

Slab Joints

 

[

]

Crawl Space

[

]

 

Soil Grade Too High

[

]

Heavy Foliage

[

]

Eaves

 

[

]

Weepholes

 

[

]

 

Other

[

]

Specify:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7A.Conditions conducive to wood destroying insect infestation:

Yes

(Refer to Part J, Scope of Inspection)

If “Yes” specify in 7B.

 

7B.Conducive Conditions include but are not limited to:

 

 

 

 

Wood to Ground Contact (G)

Debris under or around structure (K)

[

]

Footing too low or soil line too high (L)

Planter box abutting structure (O)

[

]

Wood Pile in Contact with Structure (Q)

Insufficient ventilation (T)

[

]

Other (C) [ ]

Specify:

[

]

No

[ ]

 

 

 

 

[

]

Formboards left in place (l)

[

]

Excessive Moisture (J)

[

]

[

]

Wood Rot (M)

[

]

Heavy Foliage (N)

[

]

[

]

Wooden Fence in Contact with the Structure ( R)

[

]

8.Inspection Reveals Visible Evidence in or on the structure:

Active Infestation

 

 

Previous Infestation

Previous Treatment

 

8A.Subterranean Termites

 

Yes

[

]

No

[

]

Yes

[

]

No

[

]

Yes

[

]

No

[

]

8B.Drywood Termites

 

Yes

[

]

No

[

]

Yes

[

]

No

[

]

Yes

[

]

No

[

]

8C.Formosan Termites

 

Yes

[

]

No

[

]

Yes

[

]

No

[

]

Yes

[

]

No

[

]

8D.Carpenter Ants

 

Yes

[

]

No

[

]

Yes

[

]

No

[

]

Yes

[

]

No

[

]

8E.Other Wood Destroying Insects

 

Yes

[

]

No

[

]

Yes

[

]

No

[

]

Yes

[

]

No

[

]

Specify:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8F.Explanation of signs of previous treatment (including pesticides, baits, existing treatment stickers or other methods) identified:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8G.Visible evidence of:

 

has been observed in the following areas:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If there is visible evidence of active or previous infestation, it must be noted. The type of insect(s) must be listed in the first blank and all identified infested areas of the property inspected must be noted in the second blank. (Refer to Part D, E & F, Scope of Inspection)

 

Licensed and Regulated by the Texas Department of Agriculture, Structural Pest Control Service,

 

 

PO Box 12847, Austin, Texas 78711-2847

 

SPCS/T-4

(Rev. 09/01/07)

(512) 305-8250

Buyer’s Initials

 

 

 

 

 

 

TEXAS OFFICIAL WOOD DESTROYING INSECT REPORT

 

 

 

 

Page 2 of 2

The conditions conducive to insect infestation reported in 7A & 7B:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9.Will be or has been mechanically corrected by inspecting company:

 

 

 

 

 

 

 

 

 

Yes

[

]

No

[

]

 

If “Yes,” specify corrections:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9A.Corrective treatment recommended for active infestation or evidence of previous infestation with no prior treatment

 

 

 

 

 

 

 

 

 

as identified in Section 8.

(Refer to Part G, H, and I, Scope of Inspection)

 

 

 

 

 

Yes

[

]

No

[

]

 

9B.A preventive treatment and/or correction of conducive conditions as identified in 7A & 7B is recommended as follows:

Yes

[

]

No

[

]

 

Specify reason:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Refer to Scope of Inspection Part J

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10A.This company has treated or is treating the structure for the following wood destroying insects:

 

 

 

 

 

 

 

 

 

 

 

 

If treating for subterranean termites, the treatment was:

 

Partial

[

]

Spot

[

]

Bait

[ ]

Other

[ ]

 

 

 

 

If treating for drywood termites or related insects, the treatment was:

Full

[

]

Limited

[

]

 

 

 

 

 

 

 

 

 

10B.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Treatment by Inspecting Company

 

 

Common Name of Insect

 

 

Name of Pesticide, Bait or Other Method

This company has a contract or warranty in effect for control of the following wood destroying insects:

 

 

 

 

 

 

 

 

 

 

 

 

Yes

[ ]

No

[ ]

List Insects:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If “Yes”, copy(ies) of warranty and treatment diagram must be attached.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diagram of Structure(s) Inspected

The inspector must draw a diagram including approximate perimeter measurements and indicate active or previous infestation and type of insect by using the following codes: E- Evidence of Infestation, A-Active; P-Previous; D-Drywood Termites; S-Subterranean Termites; F-Formosan Termites; C-Conducive Conditions; B-Wood Boring Beetles; H- Carpenter Ants; Other(s) – Specify

╔═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═╗ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─

═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═

─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─

═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═

─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─

═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═

─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─

═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═

─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─ ─┼─┼─┼─┼─┼─┼─┼─┼─┼─

╚═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═ ═╝

Additional Comments

Neither I nor the company for which I am acting have had, presently have, or contemplate having any interest in the 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.

Signatures:

Notice of Inspection Was Posted At or Near

 

 

 

11A.

12A.

Electric Breaker Box

[

]

 

 

 

Inspector

 

Water Heater Closet

[

]

 

 

 

 

 

Bath Trap Access

[

]

 

Approved:

 

Beneath the Kitchen Sink

[

]

 

11B.

12B.

Date Posted

 

 

 

 

 

Certified Applicator and Certified Applicator License Number

 

 

 

Date

 

 

 

 

 

 

 

 

 

 

Statement of Purchaser

I have received the original or a legible copy of this form. I have read and understand any recommendations made. I have also read and understand the “Scope of Inspection.” I understand that my inspector may provide additional information as an addendum to this report.

If additional information is attached, list number of pages:

Signature of Purchaser of Property or their Designee

Date

 

 

 

 

 

 

SPCS/T-4 (Rev. 09/01/07)