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: Street Address * City * Postal Code * 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. Location * Please describe where on your property any municipally-owned catch basins are located. Safe Access Please ensure there is clear and safe access to the catch basin(s). Check the boxes that apply: Locked access. Please phone ahead. Dog in yard. Please phone ahead. By submitting this waiver I am giving permission for employees and agents of WDG Public Health and the Canadian Centre for Mosquito Management Inc. to enter onto my property and to apply larvicide to municipally-owned catch basins that exist on my property. Name of owner/occupier * Daytime phone number * Email Address *
