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Thursday, June 20, 2013
Request Service
Orange County Vector Control District • Online Service Request Form

Insect Identification Form

Mosquito Fish Pick-Up Form

Mosquito Fish Pick-Up Form

Dead Bird

Please Call the District
to 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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