OFN Rancho San Joaquin

Occupants Fumigation Notice and Pesticide Disclosure

Address:​ Irvine, CA 92612 
☐ Single Family Dwelling ☒ Multi Family Dwelling ☐ Other _________________________________________
Full Name: Phone: Emergency Phone:  
Optional Secondary Contact
Full Name: Phone: Emergency Phone:   
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

Dates of Fumigation: April 19th through April 21st    -    Initials

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 

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Document name: OFN Rancho San Joaquin
lock iconUnique Document ID: 8c69f7afc487e76dbb4a1add437a66c087ceebb1
Timestamp Audit
March 7, 2023 1:52 pm PDTOFN Rancho San Joaquin Uploaded by Accurate Termite and Pest Control - fumigations@accuratetermitecontrol.com IP
March 7, 2023 2:02 pm PDT Document owner alex@accuratetermitecontrol.com has handed over this document to fumigations@accuratetermitecontrol.com 2023-03-07 14:02:08 -