37 MASON STREET - TRASH COMPLAINT CITY OF SALEM, MASSACHUSETTS
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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.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: ! Received By:
Complaint Number: 2247
Complainant �9
Address: Fi% ✓ L. ; /V; <, Phone:
B Investigated : Date:
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Property Owner/Occupant Name Telephone#:
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