Accurate HOA Fumigation

OFN 1177 S Wellesley Ave

Occupants Fumigation Notice and Pesticide Disclosure

Address:​ , Los Angeles, CA 90049 
☐ Single Family Dwelling ☒ Multi Family Dwelling ☐ Other _________________________________________
Full Name: Telephone Number:
Emergency Contact Full Name:
Fumigation Contractor: NEXT GENERATION FUMIGATION Emergency Number: 818-515-2387
Target Pest(s): ☒ Drywood Termites ☐ Beetles ☐ Other(s)N/A
Fumigants proposed to be used: ☐ Methyl Bromide ☒ Sulfuryl Fluoride: Vikane
                                                                                                            (Product Name)

Chloropicrin will be used as a warning agent with fumigant

Initials: Dates of Fumigation: March 28th through March 30th 

Important – Read Carefully

This building will be fumigated with lethal gas on the date(s) indicated above. All persons and animals must vacate the premises on or before arrival of the fumigation crew.
Under no circumstances can anyone enter the building until after 12PM on the last day of fumigation, AND the fumigation company’s notice is posted, giving the time and date safe for re-entry. Initials
Are you aware of any conduits, pipes, common drains, air ducts, central vacuum systems, or any other construction elements that would allow the passage of a fumigant from the structure to be fumigated to any other adjacent or adjoining structure?
“State law requires that you be given the following information: Caution-Pesticides are toxic chemicals. Structural pest control companies are registered and regulated by the Structural Pest Control Board and apply pesticides which are registered and approved for use by the California Department of Pesticide Regulation and the United States Environmental Protection Agency. Registration is granted when the State finds that based on existing scientific evidence there are no appreciable risks if proper use conditions are followed or that the risks are outweighed by the benefits. The degree of risk depends upon the degree of exposure, so exposure should be minimized.
​If within 24 hours you experience symptoms of dizziness, headache, nausea, reduced awareness, slowed movement, garbled speech, or difficulty in breathing, leave the structure immediately and seek medical attention by contacting your physician or Poison Control Center (see below) and notify your pest control company. The warning agent, chloropicrin, can cause symptoms of tearing, respiratory distress, and vomiting. Entry into the space during fumigation can be fatal.
For further information, contact any of the following: Accurate Termite and Pest Control 888 584 7187; for Health Questions – the County Health Department (see below); for Application Information – the County Agricultural Commissioner (SEE BELOW) and for Regulatory Information contact the Structural Pest Control Board, 800) 737-8188, 2005 Evergreen Street, Suite 1500, Sacramento, CA 95815-3831.

For Health Questions

County Health Department County Agricultural Commissioner
Los Angeles 213-351-7800 Los Angeles 626-575-5466
Orange 714-834-7700 Orange 714-955-0100
Riverside 951-358-5172 Riverside 951-955-3000
San Bernardino 909-884-4656 San Bernardino 909-387-2105
San Diego 619-515-6555 San Diego 858-694-8980
Santa Barbara 805-861-5102 Santa Barbara 805-681-5600
Ventura 805-652-5754 Ventura 805-933-2926

Poison Control Center - ALL OF CA Structural Pest Control Board
800-876-476 6800-737-8188

We suggest that you notify neighbors of the date of the fumigation and keep pets away during the fumigation. Close off any open access to the subarea to prevent pets from entering.
​I hereby acknowledge receipt of a copy of this document as well AS a list that includes the instructions for the necessary preparations for the fumigation and procedures for leaving the structure

Date: June 8, 2023


Occupants Fumigation Notice and Disclaimer

Read carefully- state law requires your signature. it is the responsibility of the owner, or owners agent,
to have all items on this checklist done before the crew arrives; failure may postpone the fumigation

TEL 818-515-2387

Chemical: Vikane
The crew’s estimated time of arrival is approximate only. Allow a minimum variance of two hours as traffic, wind, rain, etc., may delay our arrival. Due to unforeseen problems or safety reasons, we may require that the structure be vacated for an additional 24 hours. Wind and rain may necessitate the postponement of your job. We can not endanger our employees or your structure in adverse weather conditions. Please note that we do not work on Sundays or Holidays. If your fumigation falls within a weekend or holiday, please make sure to allow for the extra day(s) that you will be out of the structure.

On the first day the structure is covered and the fumigant introduced. During this time a minimum of one operable window per room will be open at least 3 inches. On the next workday the aeration process begins. The final step is certification for re-entry which should occur by 6 PM. For a Vikane fumigation this is the day the tarp is removed, and it will be posted on the doors that it is safe for re-entry. We WILL make every effort to have you back into your structure by 6 PM, barring UNFORESEEN circumstances.

Under no circumstances may anyone enter the structure until it has been declared safe for re-entry by a licensed fumigator. Anyone entering the structure prior to the re-entry time is violating the California Structural Pest Control Act. This is punishable by a fine of one thousand dollars, six months in jail, or both.
Although the fumigant has been AERATED from the structure, the warning agent may remain. If this occurs, open all windows for two or more hours. Running the heater may also help. damp conditions may cause the warning agent to linger.

If you experience symptoms of dizziness, headache, nausea, reduced awareness, slowed movement, garbled speech or difficulty in breathing, leave the structure immediately and seek medical attention by contacting your physician or Poison Control Center and notify your termite company. The warning agent, Chloropicrin, can cause symptoms of tearing eyes, respiratory distress and vomiting. Entry into the structure during the FUMIGATION CAN BE FATAL.

Structural fumigants are colorless, odorless and do not affect paints, or finishes. Dishes and utensils can be used without washing, as the chemical does not leave a residue.
It is the responsibility of the homeowner; occupant or homeowners agent to have all of the items on this checklist done before the crew arrives. Failure to do so may postpone the fumigation. Any problems resulting from non-compliance to this checklist by the homeowner, occupant or homeowners agent will not be the liability of the accurate termite and pest control or Next Generation Fumigation to resolve or correct. Any delays caused by any units’ failure to prepare may result in a delay fee of no less than $350.00 plus any secondary costs including legal fees, locksmith fees, loss of time and damages incurred by Accurate Termite and Pest Control, Management, and affected units will be imposed on the unprepared unit.

  1. Remove all people from the property to be fumigated.
  2. Remove all pets (including fish and birds). The water in the fish tank does not need to be drained. Animals must be removed from the yard (cats included). Please notify your neighbors of the same and ask them to keep their pets away from your property.
  3. Remove all interior or exterior plants, whether potted or hanging on/in the building(s).
  4. Remove all vehicles and boats from the garage/carport if included. If a vehicle is left in the garage, the doors and trunk must be left open—we will not accept car keys.
  5. Remove all mattresses enveloped with plastic covers such as baby mattresses, etc. Mattresses in plastic ZIP covers need to be unzipped, the same holds true for garment bags. This does not apply to waterbeds.
  6. Bag or remove all foods and medicines. This includes anything that is orally ingested, including candy and gum. It also includes food in freezers or refrigerators. In lieu of removal, these items may be placed in 2 NYLO-FUME BAGS with the ends twisted and sealed with tape. Food items, medicine & plants not removed or properly bagged will be discarded. This will result in an additional fee of no less than $350.00. Fumigators are not responsible for items we remove, bag, or miss. FOOD MUST BE BAGGED OR REMOVED AS REQUIRED BY STATE LAW.
  7. Damage may be unavoidable to plants close to the building. Please move away any other objects that may be stored against the building at least 18 inches outward from the structure. Plants under covered patios, covered entries and big eaves may die. Plants with root systems under the fumigation may also die.
  8. The occupant must turn off any air conditioning unit. We will assume no responsibility for any damage to any air conditioning unit.
  9. We must have access to all areas within the structure, including all rooms, closets, storage areas, or garages normally kept locked. If walk-in or large safes exist, you must be present to open the same for our inspection before re-locking the safe. THIS IS REQUIRED BY LAW.

Unit Access Information: 

  1. We will assume no responsibility for any damage or misaligned antennae.
  2. To ensure complete gas ventilation, the fumigator may sometimes have to open your drawers or cabinet work and closets; you may wish to do this prior to the fumigator’s arrival.
  3. Although your Homeowner’s Insurance should cover burglary, just as if it occurred at any other time, we suggest that you REMOVE CASH, VALUABLE JEWELRY, WEAPONS, or any other valuables during the fumigation. We are not responsible for losses occurring while the building is unattended.
  5. I/We the undersigned have read reviewed and agreed to all the provisions contained herein and have acknowledged receipt of an exact copy of the “Occupant’s Fumigation Notice” and disclaimer. I/We further stipulate that if the building(s) have tenant occupants, that I/we or our authorized agent or manager, will deliver copies of the paperwork to all such occupants by the use of the U.S. Mail, fax, posting on the front door or hand delivery and shall be responsible for complying with the requirements as stated herein.
  6. I/We shall absolutely observe and abide by all reasonable precautionary measures including but not limited to those set out on the Occupant’s Fumigation Notice and Disclaimer. I/we shall defend, indemnify and hold harmless Accurate Termite and Pest Control and Next Generation Fumigation for liability for any damage or injury to the owner or any other party or any property when such damage or injury results from the owner’s, tenant’s or agent’s failure to take reasonable precautionary measures concerning the work to be performed under this agreement or fails to observe and abide by each and every point set out on this Notice and Disclaimer.
  7. Satellite dishes or parabolic antennas may be knocked out of alignment. Neither Accurate Termite and Pest Control nor Next Generation Fumigation will arrange for realignment service nor will any reimbursement be made for such services.
  8. If the fumigation process requires a SCG/PG&E/SDG&E technician to access the unit in order to disconnect and/or reconnect service, SCG/PG&E/SDG&E is permitted to perform necessary procedures in the occupant’s absence.



Terms, Conditions and Liabilities

We hope that your fumigation will be problem free, however there are at times unavoidable problems. We are providing the following information so that you may be made aware of possible unavoidable circumstances.

  1. Climbing plants, trellises and vines must be removed or detached from the structure prior to the fumigation and if the homeowner/occupant has not done this, any damage to the same will not be our liability.
  2. If rain or high winds start after the fumigation has begun and should damage result from these conditions, we will not be responsible for any resulting damage.
  3. Forcible entry, if necessary, when all keys are not provided, will result in damage. The Fumigation Company and its contractors will not be responsible for repairs.
  4. The use of masking tape used during a “tape and seal” fumigation may result in the peeling of paint when the paint is old or oxidized. Some painted surfaces will chip or peel if the undercoating was not properly applied, even though these surfaces may appear to be in good condition. The tape we use will not peel paint that is properly applied; therefore, we assume no responsibility for any such damage.
  5. While we are concerned about your property, some of the following may be unavoidable due to the nature of the job that must be performed. The roof surface and perimeter areas of the building must be walked upon and damage may occur. Neither Accurate Termite and Pest Control and Next Generation Fumigation will assume any liability for such damage or consequential damage that may occur to roof or roof covering and areas below the same; gutters, electrical wiring, patio and awning covers, solar heating panels or related plumbing and living plants or landscaping at or adjacent to the property. Due to the fragile nature in which mobile homes are constructed, some damage may occur to carports, roof rails, roofs, siding, skirting, awnings, trims, vents and chimneys.
  6. If additional time is needed for safety reasons or a longer exposure period, the Fumigation Company and contractor apologize for any inconvenience or cost you may incur due to the delay. We will not be responsible for any cost resulting from any inconvenience, as it is necessary for your protection and quality fumigation.
  7. Gas must be turned off. NATURAL GAS: If you are a SCG/PG&E/SDG&E customer, only SCG/PG&E/SDG&E can disconnect and reconnect service.
  8. We do not provide on-site security during the fumigation procedure or after the tent(s) or seals are removed and as such our insurance does not cover malicious vandalism or theft, (during the fumigation process screened windows will be left open and unlocked for fumigant circulation and ventilation of the building). If the homeowner or occupant wishes such security, it would be at his/her additional expense for such arrangements, and is NOT the liability of Accurate Termite and Pest Control and Next Generation Fumigation.
  9. All exterior doors (including water heater cabinets) on the building being fumigated, must be able to be locked. If no hasp or other lockable interior/exterior locking devices EXISTS, state law requires nailing these doors shut. If the homeowner or his/her agent has not provided such locks and nailing is then performed by the fumigation company, we will not assume any liability for damage to the door jamb, window frame, wall or adjacent areas. Nailing or locking is required by state law to keep any person such as a small child from being accidentally trapped inside.
  10. Accurate Termite and Pest Control and Next Generation Fumigation will not be liable for any harm that may result from plants or pets not being properly protected as set forth herein.



By signing my name above, I am stating that I have read all statements and conditions explained in the Occupants Fumigation Notice as well as this disclaimer. I have received a copy of the Vikane/master fume Fact Sheet.

Date: June 8, 2023

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Signature Certificate
Document name: OFN 1177 S Wellesley Ave
lock iconUnique Document ID: 11b7a6a5100257510f50a2390dc3ccbf5f849dac
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February 21, 2023 12:12 pm PDTOFN 1177 S Wellesley Ave Uploaded by Alex Benitez - IP