Mosquito Spraying Avoidance Request

I DO NOT wish for my property to be included in the adulticiding (ground spraying) service provided by mosquito control using a vehicle mounted ultra-light volume (ULV) spray machine for the following reason(s):*

BeekeeperOther

I understand that a new release form must be obtained from, completed, and returned to Mosquito Control each calendar year.

The email address below will be used to inquire if the property owner would like to renew their spray avoidance request for the following mosquito season.

I understand that a yard inspection for standing water/mosquito breeding habitat is required.

Please Note:

Mosquito Control reserves the right to spray in the case of a West Nile Virus positive test result.

Name:*

First NameLast Name

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number:*

Please enter a valid phone number.

Email Address:*

example@example.com

Signature:*

Date/Time