Mississippi Department of Agriculture & Commerce — Bureau of Plant Industry
| Company Name | #field(13937) |
| Physical Address | #field(13938) #field(13939) #field(13940), #field(13941) #field(13942) |
| Mailing Address | #if("#text(#field(13944))" == "Mailing address is same as physical address")Mailing address is same as physical address.#endif#if("#text(#field(13944))" != "Mailing address is same as physical address")#field(13945) #if(#field(13946))#field(13946) #endif#field(13947), #field(13948) #field(13949)#endif |
| Report Month / Year | #field(13951) #field(13952) |
| Licensee Name | #field(13953) |
| Work Performed This Month | #field(13954) |
| Item | Brand Name | Formulation | Beginning | Used | Purchased | End |
|---|---|---|---|---|---|---|
| #section_row_number | #text(#field(13958)) | #text(#field(13959)) | #text(#field(13960)) | #text(#field(13961)) | #text(#field(13962)) | #text(#field(13963)) |
| Customer | #text(#field(13969)) #text(#field(13970)) |
| Property Address | #text(#field(13971)) #if(#field(13972))#text(#field(13972)) #endif#text(#field(13973)), #text(#field(13974)) #text(#field(13975)) |
| Property Mailing Address | #if("#text(#field(13977))" == "Property mailing address is same as physical address")Property mailing address is same as physical address.#endif#if("#text(#field(13977))" != "Property mailing address is same as physical address")#text(#field(13978)) #if(#field(13979))#text(#field(13979)) #endif#text(#field(13980)), #text(#field(13981)) #text(#field(13982))#endif |
| Contractor / Owner | #text(#field(13984)) |
| Subdivision / Lot | #text(#field(13985)) / #text(#field(13986)) |
| Date of Treatment | #text(#field(13987)) |
| Treatment Type | #text(#field(13988)) |
| Structure Type | #text(#field(13989)) |
| PRE-CONSTRUCTION OR PRE-TREAT PERIMETER FINAL GRADE OR WOOD TREATMENT TERMITE ONLY |
EXISTING/POST CONSTRUCTION OR RETREAT/EXISTING CONTRACT OR SPOT TERMITE ONLY |
DILUTE PESTICIDE APPLIED OR TERMITE BAIT INSTALLATION |
||||
|---|---|---|---|---|---|---|
| Horizontal Barrier Treated (Sq. Ft.) |
Vertical Barrier Treated (Linear Ft.) |
Linear Ft. Treated @ 4 Gal per 10 Linear Ft. |
Linear Ft. Treated @ 2 Gal per 10 Linear Ft. |
Pesticide Brand Name OR Baiting System Brand Name |
Percent Finished Solution | Total Gal Applied OR # of Bait Stations Installed |
| #text(#field(13993)) | #text(#field(13996)) | #text(#field(13994)) | #text(#field(13997)) | #text(#field(13995)) | #text(#field(13998)) | #text(#field(13999)) |