22 TREMONT STREET - TRASH COMPLAINT y,
CITY OF SALEM, MASSACHUSETTS
J. BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,e"FLOOR
t MAYOR TEL.(978)741-1800
t 1' FAx(978)745-0343
!1 LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDINASALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: Received By:
Complaint Number: 2354
Complainant
Address: Phone:
Investigated By: - Date:
Property Owner/Occupant Name _ Telephone #:
p