40 SCHOOL STREET - TRASH COMPLAINT to m CITY OF SALEM,MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4TH FLOOR
MAYOR A (978)741-1800 F
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LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDINriSALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: l Time: �� . :: � Received By:
Complaint Number: 2254
Complainant
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Investigated By: Date:
Property Owner/Occupant Name_ - Telephone #