Orange County Vector Control District

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Wednesday, February 22, 2012

Request Service

Orange County Vector Control District • Online Service Request Form

Insect Identification Form

Mosquito Fish Pick-Up Form

Report a Dead Bird

To request service please complete the form below and then press the "Submit" button at the bottom of the page.
Fields marked with '*' are required.

*E-mail:

A valid e-mail is required.Minimum number of characters not met.A valid e-mail is required.

This is regarding someone else's property.

First Name:

Last Name:

*Why are you placing this Service Request?:

Please select a valid reason.Please select an reason.

This is the location of the problem.

Site/Company Name:

*Address:

A valid address is required.Minimum number of characters not met. *Street Type: Please choose NONE if there is no Street Type.

*Unit Type:

Please select a valid unit type.Please select a valid unit type.

Unit Number:

*City:

A valid city is required.Minimum number of characters not met.

*State:

A valid State is required.Minimum number of characters not met.Exceeded maximum number of characters.Invalid format.

*Zip Code:

A valid zip code is required.Minimum number of characters not met.Invalid format.

*Cross Streets:

(example: Brookhurst & Ellis)

A valid cross street is required.Minimum number of characters not met.

*Daytime Phone:

A valid phone number is required.A valid phone number is required.A valid phone type is required.A valid phone type is required. Please select a valid type.Please select a valid type.

Evening Phone:

A valid Phone Number is required.A valid Phone Number is required.

*Are there dogs on the property?:

Please select if you have dogs.Please select if you have dogs.

Gated Community:

Gate Code:

or Guard

Comments:

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