24 CABOT STREET - TRASH COMPLAINT CITY OF SALEM,MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4"FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDIN_SALEM.001M
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: 7- �-//' Time: Received By: —)/'/j i
Complaint Number: 1719
Complainant i
Address: Phone:
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Investigated By: Date:
Property Owner/Occupant Name -4 Telephone
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