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2. FUMIGATION HOUSE CHECK

   Alhambra Police Department

4. Name
5. Phone Number
6. Email
8. Fumigation House Check Address
9. Premises Phone Number
11. Fumigation Start Date
    Fumigation Start Date
12. Fumigation End Date
    Fumigation End Date
14. Is there a house alarm?

    1. Yes
    2. No
15. If yes, please provide the Alarm Company and phone number:
17. Will the Officer have access to the backyard?

    1. Yes
    2. No
19. Will all the doors, windows and garage entries be locked?

    1. Yes
    2. No
20. If no, please explain:
22. Will there be vehicle(s) in the driveway?

    1. Yes
    2. No
23. If yes, please describe vehicle(s):
25. List person(s) authorized to be on the premises (gardener, pool service, relatives, etc.). If none, write "none":
27. Fumigation Company Name
28. Fumigation Company Contact Information
30. Name
31. Phone Number
33. Address
34. Relationship:
36. Special instructions for Fumigation Check Personnel:
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit Submit and Print

* indicates a required field