8.5 ALLEN STREET - TRASH COMPLAINT (2) 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 LRAMDIN(e)SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: Received By:
Complaint Number: 2290
Complainant
Address: Phone:
Investigated By: _ _ Date:
Property Owner/Occupant Name_ Telephone#: