80 Summer Street Complaint 7-24-2019 �� NWTg1
'4n x 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 RAMDTN,RS/REHS,CHO,CP-FS LRAMDTNifi SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
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Date: 2 Time: ? 5 Received By: 5;
Complaint Number: 2503 rI
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Address: v Phone: q7�s�go3
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