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8 GRANITE STREET - TRASH COMPLAINT �« CITY OF SALEM, MASSACHUSETTS WF W�,t�'� 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 LRAMDIN(0�1SALEM"COM HEALTH AGENT COMPLAINT INTAKE FORM Date: ' ' e:.)^.Z Time: Received By: ier r o Complaint Number: 177114 Complainant Address: () rn-r, , +�, -gree f Phone: Cnn�-�"vC+1 on d o 01r s r /In �j CID rn 4Ae_ LA o4- � �rr6+�, fe �✓ee f, AS�iPQ�I -}hc►r e a C-10ilki r°I Q+ nan± � a. S We-ii )9e-y4i i-016s4 T S e v- 7 t ,/ S " e 1 p 4YI e- %e o,r' ©f i'i° s' I«f J IrnW,- C .� Investigated By: Date: Property Owner/Occupant Name Telephone #: