Mosquito Spraying Avoidance Request

2. 

4. 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):

   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):

6. Reasons:

   1. Beekeeper

   1. Other (Please Explain)

8. Other (Please Explain):

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

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

14. Name:*

15. Phone:*

17. Address:*

19. Email Address:*

21. Electronic Signature:*

22. Date:*
    Date:

Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

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