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). To: Dr. Nicola Mercer, Medical Officer of Health, WDG Public HealthRe: Catch basin larvicide treatmentI 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 all 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 Leave this field blank Section navigation Insects, animals and bites Animal Exposures and Rabies Backyard Birds Mosquitoes Catch Basin Larvicide Treatment Waiver Form Mosquito Management in our Community Mosquito-borne Diseases Ticks Tick-borne Diseases Zoonotic Diseases in Ontario Share this page