Catch Basin Larvicide Treatment Waiver Form

If you have a catch basin on your property and would like it treated, complete and submit the form below or use the Larvicide Waiver form (PDF, 1 page, 90 kb).


To: Dr. Nicola Mercer, Medical Officer of Health, WDG Public Health

Re: Catch basin larvicide treatment

I am the owner/occupier of:

To protect the public from the West Nile virus, the Medical Officer of Health for WDG Public Health has initiated a mosquito-control program to eliminate mosquitoes that carry and transmit the West Nile virus. Part of the program involves treating municipally-owned catch basins on private property.

Please describe where on your property any municipally-owned catch basins are located.
Please ensure there is clear and safe access to the catch basin(s). Check the boxes that apply: