14 ABORN STREET - TRASH COMPLAINT �fA
CITY OF SALEM3 MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4 T'FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP—FS LRAMDIVel SALF'M.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: �/i
Time: Received By:"'.. I
Complaint Number: 1769
Complainant
Address: Phone:
4 Lcz�4
Investigated By , Date:
Property Owner/Occupant Name Telephone #:
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