12-14 WARD STREET - TRASH COMPLAINT is1 CITY OF SALEM, MASSACHUSETTS
e BOARD OF HEALTH
^ KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4''FLOOR
MAYOR TEL.(978)741-]800
FAX(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDINCa'SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Lt3 Time: 2; Received By: t r ;y
Complaint Number: 1744
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