7 SUMMIT STREET - RODENT COMPLAINT j�n uiri:'\
CITY OF SALEM,MASSACHUSETTS
yam' 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 LRAMDINASALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: Received By: -_
Complaint Number: 2188
Complainant
Address: 1 - Phone: 7 - VI
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Investigated By: Date:
Property Owner/Occupant Name Telephone #: -
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