4 FLORENCE STREET - TRASH COMPLAINT a CITY OF SALEM,MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,41H FLOOR
MAYOR (978) -1800 FAx
FAx(978)745-0343343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDINnaSALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: Received By-.
Complaint Number: 2063
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Complainant
Address: Phone:
Investigated By: Date:
Property Owner/Occupant Name Telephone#:
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