80 Margin Street Complaint 9-4-2018 a
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4T{FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMD]N,RS/REHS,CHO,CP-FS LRAMDINASALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: Received By: !4
Complaint Number: 2245
Complainant Ahex
Address: 'hone: 9 �—
Investigated By: — Date:
Property Owner/Occupant Name Telephone #:
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