West Seneca Seal
INCORPORATED 1851

STANDING WATER MONITORING REPORT

Help eliminate the West Nile Virus. Mosquitos need stagnant or standing water to lay their eggs. To reduce the mosquito population around your home, and properly reduce or eliminate all stagnant water, we are asking our residents for their help.

The Town of West Seneca is taking standing water complaints for tracking purposes in order for the Department of Health to identify potential problem areas. The Town will not be able to visit and treat all reported nuisances, therefore, we are depending on our residents and business owners to eliminate standing water on their property.


Directions:

Enter all information requested below by typing on the computer keyboard in the available spaces. Use the Tab button to move from box to box or use your mouse to point and click. Use your Space Bar to make checks within the boxes. After all the information is entered, use the Submit button at the bottom of the page to submit the Standing Water Monitoring Report form.


Standing Water Reported by: (We may need to contact you for additional information)

Name: 


  Address: 


Day Phone: 


Evening Phone: 


E-Mail Address: 


Zip Code: 


Today's Date: 


Date water was
first noticed: 




Standing Water Information:

 Unclorinated Swimming Pool
 Swimming Pool Cover
 Discarded Tires
 Catch-Basin / Sewer
 Depression in Street (example: pot holes, poorly paved street, etc.)
 Ditch in Ground
 Small containers (example: bucket, etc.)
 Large Containers (example: Children's Wading Pool, garbage can, refrigerator, etc.) Roof Top
 Marsh / Swamp
 Pond
 Roof Gutters
 Other:  


Classify the Standing Water as:

 Small (example: bucket, children's wading pool, etc.)
 Medium (example: swimming pool)
 Large (example: large outside area is flooded)


Location of Standing Water:

 Private House
 Apartment Building
 Business / Commercial Property
 Vacant Lot (Abandoned house, non-active construction site, et.)
 Public Property (Please specify site name)
 Other:  


Comments:






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