9 Boardman Street Complaint 7-29-2019 CITY OF SALEM, MASSACHUSETTS
a BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4TH FLOOR
MAYOR TEL.(978)741-1800
FAx(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDINQSALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: _ Time: _ Received By:
Complaint Number .2514_
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Investigated By: __..... _ Date:
Property Owner/Occupant Name _ Telephone #: __